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KMID : 0365719950110010048
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Journal of Pusan Surgical Society
1995 Volume.11 No. 1 p.48 ~ p.55
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Early Clinical Experience with the Valtrac BAR for Bowel Anastomosis
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이대영
최홍조/김형호/김영훈/조세헌/정갑중/김상순
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Abstract
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The concept of anastomois without suture is not new. The ideal device for sutureless bowel anastomosis contains no foreign material, is easy and quick to construct, is safe even in cases of increased intraluminal pressure and causes virtually no
granulation tissue or scarring. The Valtrac biofragmentable anastomosis ring was introduced to fulfill theses criteria in 1985.
Forty three bowel anastomoses were attempted in 41 patients with a Valtrac biofragmentable anastomosis ring(BAR) for sutureless bowel anastomosis. Patients ranged in age from 18 to 83 years(mean 51.8), with following diagnoses : primary colon
cancer, 12
; previous colostomy, four ; benign colon ulcer, three ; small bowel tumor, three ; primary gastric cancer, three ; traumatic jejunal perforation. two ; colopelvic renal fistual. cystic jejunal duplication, bladder tumor, transsexulism, recurrent
gastric cancer. tuberculous cystitis, one each. Operations were performed as elective one in 30 and emergency in 11. Anastomoses per-formed were enterocolic (n=22), colocolic(n=11), colorectal(n=3), and enteroenteric(n=7).
In one patient the BAR was aborted and a new BAR anastomosis was performed because of concern with the blood supply to the anastomosis due to relatively extensive mucosal tear. One patient developed anastomotic leak which required hartmann-type
reoperation. There was one death(due to acute renal failure) in hospital.
The average duration from operation to resumption to regular diet was 11.7 days.
The BAR seems to be a safe and reliable alternative to conventional suture anastomosis in bowel surgery.
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