Compression anastomotic ring-locking procedure (CARP) is a safe and effective method for intestinal anastomoses following left-sided colonic resection

Dadi Vilhjalmsson; Stefan Appelros; Ervin Toth; Ingvar Syk; Anders Grönberg; Tommie Mynster; Henrik Thorlacius

doi:10.1007/s00384-015-2257-z

Compression anastomotic ring-locking procedure (CARP) is a safe and effective method for intestinal anastomoses following left-sided colonic resection

Dadi Vilhjalmsson, Stefan Appelros, Ervin Toth, Ingvar Syk, Anders Grönberg, Tommie Mynster, Henrik Thorlacius

Department of Clinical Medicine

3 Citations (Scopus)

Abstract

Background: Compression anastomotic ring-locking procedure (CARP) is a novel procedure for creating colonic anastomoses. The surgical procedure allows perioperative quantification of the compression pressure between the intestinal ends within the anastomosis and postoperative monitoring of the anastomotic integrity. We have recently shown that CARP is a safe and effective method for colonic anastomoses in pigs, and the purpose of the present study was to evaluate CARP for colonic anastomoses in humans. Materials and methods: This is a prospective study on 25 patients undergoing elective left-sided colonic resection. Time for evacuation of the anastomotic rings, perioperative compression pressure, and adverse effects were recorded. Postoperative blood samples were collected daily, and flexible sigmoidoscopy was performed 8–12 weeks after surgery to examine the anastomoses. Results: Fourteen out of 25 patients underwent CARP. CARP was not used in 11 patients due to advanced tumor disease (two cases) and size restrictions (nine cases). No case of anastomotic leakage, bowel obstruction, or stenosis formation was observed. No device-related perioperative adverse events were noted. The surgical device evacuated spontaneously in all patients by the natural route after a median of 10 days. Perioperative compression pressure ranged between 85 and 280 mBar (median 130 mBar). Flexible sigmoidoscopy revealed smooth anastomoses without signs of pathological inflammation or stenosis in all cases. Conclusion: Our results indicate that the novel suture-less CARP is a safe and effective method for creating colonic anastomoses. Further studies are warranted in larger patient populations to compare CARP head-on-head with stapled and/or hand-sewn colonic anastomoses.

Original language	English
Journal	International Journal of Colorectal Disease
Volume	30
Issue number	7
Pages (from-to)	969-75
Number of pages	7
ISSN	0179-1958
DOIs	https://doi.org/10.1007/s00384-015-2257-z
Publication status	Published - 19 Jul 2015

Keywords

Aged
Anastomosis, Surgical
Digestive System Surgical Procedures
Female
Humans
Intestines
Leukocyte Count
Male
Middle Aged
Postoperative Care
Sigmoidoscopy

Access to Document

10.1007/s00384-015-2257-z

Cite this

Compression anastomotic ring-locking procedure (CARP) is a safe and effective method for intestinal anastomoses following left-sided colonic resection. / Vilhjalmsson, Dadi; Appelros, Stefan; Toth, Ervin et al.
In: International Journal of Colorectal Disease, Vol. 30, No. 7, 19.07.2015, p. 969-75.

Research output: Contribution to journal › Journal article › Research › peer-review

@article{2211595694cc41988a3711d894adb3b8,

title = "Compression anastomotic ring-locking procedure (CARP) is a safe and effective method for intestinal anastomoses following left-sided colonic resection",

abstract = "Background: Compression anastomotic ring-locking procedure (CARP) is a novel procedure for creating colonic anastomoses. The surgical procedure allows perioperative quantification of the compression pressure between the intestinal ends within the anastomosis and postoperative monitoring of the anastomotic integrity. We have recently shown that CARP is a safe and effective method for colonic anastomoses in pigs, and the purpose of the present study was to evaluate CARP for colonic anastomoses in humans. Materials and methods: This is a prospective study on 25 patients undergoing elective left-sided colonic resection. Time for evacuation of the anastomotic rings, perioperative compression pressure, and adverse effects were recorded. Postoperative blood samples were collected daily, and flexible sigmoidoscopy was performed 8–12 weeks after surgery to examine the anastomoses. Results: Fourteen out of 25 patients underwent CARP. CARP was not used in 11 patients due to advanced tumor disease (two cases) and size restrictions (nine cases). No case of anastomotic leakage, bowel obstruction, or stenosis formation was observed. No device-related perioperative adverse events were noted. The surgical device evacuated spontaneously in all patients by the natural route after a median of 10 days. Perioperative compression pressure ranged between 85 and 280 mBar (median 130 mBar). Flexible sigmoidoscopy revealed smooth anastomoses without signs of pathological inflammation or stenosis in all cases. Conclusion: Our results indicate that the novel suture-less CARP is a safe and effective method for creating colonic anastomoses. Further studies are warranted in larger patient populations to compare CARP head-on-head with stapled and/or hand-sewn colonic anastomoses.",

keywords = "Aged, Anastomosis, Surgical, Digestive System Surgical Procedures, Female, Humans, Intestines, Leukocyte Count, Male, Middle Aged, Postoperative Care, Sigmoidoscopy",

author = "Dadi Vilhjalmsson and Stefan Appelros and Ervin Toth and Ingvar Syk and Anders Gr{\"o}nberg and Tommie Mynster and Henrik Thorlacius",

year = "2015",

month = jul,

day = "19",

doi = "10.1007/s00384-015-2257-z",

language = "English",

volume = "30",

pages = "969--75",

journal = "International Journal of Colorectal Disease",

issn = "0179-1958",

publisher = "Springer",

number = "7",

}

TY - JOUR

T1 - Compression anastomotic ring-locking procedure (CARP) is a safe and effective method for intestinal anastomoses following left-sided colonic resection

AU - Vilhjalmsson, Dadi

AU - Appelros, Stefan

AU - Toth, Ervin

AU - Syk, Ingvar

AU - Grönberg, Anders

AU - Mynster, Tommie

AU - Thorlacius, Henrik

PY - 2015/7/19

Y1 - 2015/7/19

N2 - Background: Compression anastomotic ring-locking procedure (CARP) is a novel procedure for creating colonic anastomoses. The surgical procedure allows perioperative quantification of the compression pressure between the intestinal ends within the anastomosis and postoperative monitoring of the anastomotic integrity. We have recently shown that CARP is a safe and effective method for colonic anastomoses in pigs, and the purpose of the present study was to evaluate CARP for colonic anastomoses in humans. Materials and methods: This is a prospective study on 25 patients undergoing elective left-sided colonic resection. Time for evacuation of the anastomotic rings, perioperative compression pressure, and adverse effects were recorded. Postoperative blood samples were collected daily, and flexible sigmoidoscopy was performed 8–12 weeks after surgery to examine the anastomoses. Results: Fourteen out of 25 patients underwent CARP. CARP was not used in 11 patients due to advanced tumor disease (two cases) and size restrictions (nine cases). No case of anastomotic leakage, bowel obstruction, or stenosis formation was observed. No device-related perioperative adverse events were noted. The surgical device evacuated spontaneously in all patients by the natural route after a median of 10 days. Perioperative compression pressure ranged between 85 and 280 mBar (median 130 mBar). Flexible sigmoidoscopy revealed smooth anastomoses without signs of pathological inflammation or stenosis in all cases. Conclusion: Our results indicate that the novel suture-less CARP is a safe and effective method for creating colonic anastomoses. Further studies are warranted in larger patient populations to compare CARP head-on-head with stapled and/or hand-sewn colonic anastomoses.

AB - Background: Compression anastomotic ring-locking procedure (CARP) is a novel procedure for creating colonic anastomoses. The surgical procedure allows perioperative quantification of the compression pressure between the intestinal ends within the anastomosis and postoperative monitoring of the anastomotic integrity. We have recently shown that CARP is a safe and effective method for colonic anastomoses in pigs, and the purpose of the present study was to evaluate CARP for colonic anastomoses in humans. Materials and methods: This is a prospective study on 25 patients undergoing elective left-sided colonic resection. Time for evacuation of the anastomotic rings, perioperative compression pressure, and adverse effects were recorded. Postoperative blood samples were collected daily, and flexible sigmoidoscopy was performed 8–12 weeks after surgery to examine the anastomoses. Results: Fourteen out of 25 patients underwent CARP. CARP was not used in 11 patients due to advanced tumor disease (two cases) and size restrictions (nine cases). No case of anastomotic leakage, bowel obstruction, or stenosis formation was observed. No device-related perioperative adverse events were noted. The surgical device evacuated spontaneously in all patients by the natural route after a median of 10 days. Perioperative compression pressure ranged between 85 and 280 mBar (median 130 mBar). Flexible sigmoidoscopy revealed smooth anastomoses without signs of pathological inflammation or stenosis in all cases. Conclusion: Our results indicate that the novel suture-less CARP is a safe and effective method for creating colonic anastomoses. Further studies are warranted in larger patient populations to compare CARP head-on-head with stapled and/or hand-sewn colonic anastomoses.

KW - Aged

KW - Anastomosis, Surgical

KW - Digestive System Surgical Procedures

KW - Female

KW - Humans

KW - Intestines

KW - Leukocyte Count

KW - Male

KW - Middle Aged

KW - Postoperative Care

KW - Sigmoidoscopy

U2 - 10.1007/s00384-015-2257-z

DO - 10.1007/s00384-015-2257-z

M3 - Journal article

C2 - 25989929

SN - 0179-1958

VL - 30

SP - 969

EP - 975

JO - International Journal of Colorectal Disease

JF - International Journal of Colorectal Disease

IS - 7

ER -

Compression anastomotic ring-locking procedure (CARP) is a safe and effective method for intestinal anastomoses following left-sided colonic resection

Abstract

Keywords

Access to Document

Fingerprint

Cite this