Annals of Coloproctology

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Niti CAR 27 Versus a Conventional End-to-End Anastomosis Stapler in a Laparoscopic Anterior Resection for Sigmoid Colon Cancer: Seung-Jin Kwag, Jun-Gi Kim, Won-Kyung Kang, Jin-Kwon Lee, Seong-Taek Oh; Ann Coloproctol. 2014;30(2):77-82. Published online April 25, 2014; DOI: https://doi.org/10.3393/ac.2014.30.2.77

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Purpose

The Niti CAR 27 (ColonRing) uses compression to create an anastomosis. This study aimed to investigate the safety and the effectiveness of the anastomosis created with the Niti CAR 27 in a laparoscopic anterior resection for sigmoid colon cancer.

Methods

In a single-center study, 157 consecutive patients who received an operation between March 2010 and December 2011 were retrospectively assessed. The Niti CAR 27 (CAR group, 63 patients) colorectal anastomoses were compared with the conventional double-stapled (CDS group, 94 patients) colorectal anastomoses. Intraoperative, immediate postoperative and 6-month follow-up data were recorded.

Results

There were no statistically significant differences between the two groups in terms of age, gender, tumor location and other clinical characteristics. One patient (1.6%) in the CAR group and 2 patients (2.1%) in the CDS group experienced complications of anastomotic leakage (P = 0.647). These three patients underwent a diverting loop ileostomy. There were 2 cases (2.1%) of bleeding at the anastomosis site in the CDS group. All patients underwent a follow-up colonoscopy (median, 6 months). One patient in the CAR group experienced anastomotic stricture (1.6% vs. 0%; P = 0.401). This complication was solved by using balloon dilatation.

Conclusion

Anastomosis using the Niti CAR 27 device in a laparoscopic anterior resection for sigmoid colon cancer is safe and feasible. Its use is equivalent to that of the conventional double-stapler.

Citations

Citations to this article as recorded by

New alternative colorectal anastomotic devices: A systematic review and meta-analysis
T. Shakir, T. Pampiglione, M. Hassouna, P. Rogers, J. Dourado, S. Emile, R. Kokelaar, S. Wexner
The American Journal of Surgery.2025; 240: 116128. CrossRef
Systematic Review and Meta-Analysis on Colorectal Anastomotic Techniques
Jana Steger, Alissa Jell, Stefanie Ficht, Daniel Ostler, Markus Eblenkamp, Petra Mela, Dirk Wilhelm
Therapeutics and Clinical Risk Management.2022; Volume 18: 523. CrossRef
A systematic analysis of controlled clinical trials using the NiTi CAR™ compression ring in colorectal anastomoses
R. Tabola, R. Cirocchi, A. Fingerhut, A. Arezzo, J. Randolph, V. Grassi, G. A. Binda, V. D’Andrea, I. Abraha, G. Popivanov, S. Di Saverio, A. Zbar
Techniques in Coloproctology.2017; 21(3): 177. CrossRef
Can a nickel–titanium memory-shape device serve as a substitute for the stapler in gastrointestinal anastomosis? A systematic review and meta-analysis
Ning-Ning Li, Wen-Tao Zhao, Xiao-Ting Wu
Journal of Surgical Research.2016; 201(1): 82. CrossRef
Efficacy and safety of a NiTi CAR 27 compression ring for end-to-end anastomosis compared with conventional staplers: A real-world analysis in Chinese colorectal cancer patients
Zhenhai Lu, Jianhong Peng, Cong Li, Fulong Wang, Wu Jiang, Wenhua Fan, Junzhong Lin, Xiaojun Wu, Desen Wan, Zhizhong Pan
Clinics.2016; 71(5): 264. CrossRef
The New Stapler Device Is Good, But Needs More Evaluation
Young Wan Kim, Ik Yong Kim
Annals of Coloproctology.2014; 30(2): 59. CrossRef

Clinical Aspects and Surgical Methods in Perianal Hidradenitis Suppurativa.: Hwang, Do Yeon , Park, Weon Kap , Lee, Jong Ho , Yoon, Jong Sup , Cho, Kyung A , Kim, Hyun Shig , Lee, Jong Kyun , Kim, Kwang Yun; J Korean Soc Coloproctol. 2001;17(1):20-25.

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Abstract PDF: PURPOSE
Hidradenitis suppurativa is a chronic suppurative and cicatricial inflammatory disease involving apocrine gland- bearing areas including the axilla, groin, and anogenital regions. Recurrence after surgery is not rare, and there is much debate about operative methods. This study analyzed the clinical characteristics and the relationship between different surgical methods and recurrences of perianal hidradenitis suppurativa.
METHODS
A retrospective study of 20 patients with perianal hidradenitis suppurativa was done. The clinical characteristics were examined. The patients were divided into several groups (acute, chronic regional, chronic extensive) according to lesion status; then, different operative methods and recurrence rates were compared.
RESULTS
All of the patients were male smokers. The mean age of onset was 28.4 years. The mean duration of disease was 10 years. The total number of operations, including incision and drainage, was 29 cases. Only 4 patients were overweight or obese. The most common symptom was pus discharge (52%). The recurrence rate after final surgery was 30.0%. After incision and drainage in the acute group, 7 of 8 cases (87.5%) recurred. In the chronic regional group, 5 of 9 cases (55.6%) experienced recurrence after excision and primary repair. After excision and healing by secondary intention, 1 of 7 cases (14.3%) had recurrence. In the case of one unroofing and marsupialization, there was no recurrence. In the chronic extensive group, 1 recurrence was noted in 4 unroofings and marsupializations.
CONCLUSIONS
In the case of abscess, proper incision and drainage is needed, but further definitive surgery must be done. In the case of chronic disease, if the lesions are regional, excision and healing by secondary intention is more ideal for decreasing the recurrence rate. If the lesions are extensive, unroofing and marsupialization is recom-mended.

Expression of Cyclooxygenase-2 and Inducible Nitric Oxide Synthase in Colorectal Cancer.: Yang, Keun Ho , Bae, Byung Noe , Kim, Jung Yeon , Kim, Ki Hwan , Han, Se hwan , Kim, Hong Joo , Kim, Young Duck , Kim, Hong Yong , Kim, Sung Jun; J Korean Soc Coloproctol. 2003;19(3):144-150.

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Abstract PDF: PURPOSE
Recently, it has been recognized that both cyclooxygenase-2 (COX-2) and inducible nitric oxide synthase (iNOS) produce important endogeneous factors of human tumor progression. The aims of this study is to investigate the correlation between the expression of COX-2 and iNOS and to assess the clinicopathological significance of COX-2 and iNOS expression in patients with colorectal cancer.
METHODS
One hundred and five patients, who underwent curative resection of colorectal cancer from 1994 to 1997 were analyzed retrospectively. The monoclonal antibody to the COX-2 and iNOS were used for the immunohistochemical analysis.
RESULTS
In 105 patients the COX-2 and iNOS positive rate were 86.7% and 69.5% respectively. There was significant correlation between COX-2 and iNOS expression (r= 0.378, P<0.01), that is, the lesions which expressed high level of COX-2 also expressed iNOS highly. The proliferation index (Ki-67 labeling index) was correlated with iNOS (P=0.013), and the microscopic differentiation with COX-2 (P=0.004). However, the expression of COX-2 and iNOS proteins did not correlate with any other clinicopathological parameters including patient survival.
CONCLUSIONS
Although the pattern of positive expression was similar in both enzymes, the expression of both enzymes was not related to prognosis in patients with colorectal cancer. But COX-2 and iNOS seems to have a role not only in carcinogenesis but also tumor cells proliferation. To evaluate the exact role of these enzymes, further studies of the apoptosis and cancer metastasis and of links between the cancer related factors of COX-2 and iNOS are warranted.

Case Report

A Case of Linitis Plastica Type of Appendiceal Adenocarcinoma.: Kim, Jeong Soo , Jeon, Hae Myung , Lee, Eun Jung , Kim, Jae Sung; J Korean Soc Coloproctol. 1999;15(2):141-144.

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Abstract PDF: Primary tumor of the appendix is a rare disease entity of gastrointestinal malignancy. Most of them are discovered unexpectedly in an acute situation. The diagnosis of adenocarcinoma of the appendix is hardly made preoperatively. An unsuspected finding of appendiceal tumor during operation can cause confusion about appropriate management of the lesion. The prognosis of adenocarcinoma of appendix can be determined by Dukes' stage and is similar, stage for stage, to that of colorectal carcinoma. We experienced a patient with linitis plastica type of primary adenocarcinoma of the appendix, who complained right lower quadrant pain for twenty days. The patient underwent appendectomy only. The second curative operation could not be performed due to patient's condition.

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