The use of suture in anastomosis presents some theoretical disadvantages that they would be avoided by using sutureless intestinal anastomosis. The biofragmentable ring idealized by Hardy et al.(1985), is composed by polyglycolic acid and barium sulfate. It is constituted by two identical components that are coupled, not returning to the original position after its occlusion. This ring suffers desintegration in 2 to 3 weeks, and is eliminated with evacuation. This device allows a sutureless anastomosis by the compression of intestinal walls. The purpose of this prospective and randomized study was to compare the clinical and endoscopic results in eletive and low risk colonic anastomosis accomplished with biofragmentable anastomosis ring and with non absorbable suture. MATERIAL: Thirty-six patients were stratified in two groups of 18 that were denominated Group I (biofragmentable anastomosis ring) and Group II (non absorbable suture). The average age for Group I was 36 years and for Group II was 42. The most frequent surgical indication in both groups was reconstruction of the intestinal flow after colostomy. All patients were submitted to biochemical blood tests, nutritional and surgical risk evaluation. The statistical analysis used for comparison between groups demonstrated that they were homogeneous. RESULTS: Comparative analysis of the intraoperative period parameters revealed that the anastomosis with biofragmentable anastomosis ring is faster ant there are no significant differences regarding intraoperative complications rate, period of ileus, time to reintroduce the oral diet, mortality and long term folloow-up. The incidence of anastomotic leak was higher in the Group I . The endoscopic analysis demonstrate no difference because there was the same results for both groups . There was a significant higher incidence of exposed suture in suture anastomosis when compared to biofragmentable anastomosis ring. CONCLUSIONS: It can be concluded that the biofragmentable anastomosis ring allowed the accomplishment of colon anastomosis more quickly, and regarding clinical complications, similar to the use of non absorbable suture. This anastomosis method presented the inconvenience of determining higher incidence of anastomotic leak while as advantage it established presence of exposed suture in the anastomosis in smaller percentage.
Colon Surgery; Anastomosis; Suture
