Anastomosis colorrectales por compresión utilizando el dispositivo NiTi

Abstract

BackgroundThe most severe complication following an intestinal anastomosis is the dehiscence with the consequent development of sepsis, fistulas, stenosis, and death. For this reason the compression anastomosis (NiTi) system was developed, with the aim of reducing these complications. Material and methodsA retrospective study was conducted, from 1 June 2012 to 30 August 2014, on total of 14 patients operated on the Humanitas Hospital Medical Group Coyoacán, the ASMED, and Clínica Médica Sur. The subjects were predominantly male 65%, a mean age of 58 years, with range 30-79 years. ResultsA total of 14 patients were included. The indication for surgery was complicated diverticular disease Hinchey II-III (36%), and the procedures performed were: 6 (43%) left hemicolectomy with primary end to end compression anastomosis, 2 (14%) major complications (dehiscence wall and anastomosis), 1 (7%) minor complication (infection of the soft tissues). There was a mean 98ml (range 20-300ml) of intraoperative bleeding, with start of oral feeding on the second day, a mean hospital stay of 4 days (range 2-10), one patient with ileo-rectal anastomosis dehiscence presented on the 4th post-operative day, and performing anastomosis with stapling device and loop ileostomy. Stenosis developed in 7% during follow-up and was resolved with a new anastomosis stapler. ConclusionsThe NiTi device is an additional alternative for colorectal anastomosis, mainly in low anastomosis, obtaining good results in this study without major complications.