Biofragmentable anastomosis ring in emergency surgery

Background: The biofragmentable anastomosis ring (BAR) proved its usefulness in elective bowel surgery. Aims: To verify the validity of the BAR in restoring bowel continuity in emergency. Material and Methods: The authors retrospectively evaluated the results of 62 intestinal resections and primary anastomoses with the BAR performed in 53 consecutive patients undergoing single-stage surgery for acute abdomen. No patients had either preoperative bowel preparation or intraoperative intestinal lavage. Results: No proximal ileostomy or colostomy was used. A single anastomosis was made in 47 patients, while the remaining 6 patients underwent multiple intestinal resections with primary anastomoses. Forty-nine of the 53 patients had an uneventful recovery. Anastomotic leakage occurred in 2 patients (3.2 %) operated on for an obstructing carcinoma of the left colon. One patient was successfully treated with a period of total parenteral nutrition, whereas the other required reoperation for a complete anastomotic leak due to failed closure of the device which was re-inserted successfully. Two patients (3.7 %) died postoperatively of myocardial infarction and hepato-renal syndrome. Conclusions: Although this is a non-randomised trial, these results suggest that the BAR can be employed effectively in the emergency setting, even when single-stage intestinal surgery is performed.