The Use of a Compression Device as an Alternative to Hand-Sewn and Stapled Colorectal Anastomoses: Is Three a Crowd?

The NiTi CAR (TM) 27 is a newer device that uses compression to create an anastomosis. An analysis of this device in the creation of colorectal anastomoses in humans has yet to be reported in the USA. A non-randomized, prospective pilot study of the NiTi CAR (TM) 27 device in patients undergoing a left-sided colectomy between March 2008 and August 2009 was performed. Twenty-three patients (9 men and 14 women) underwent a left-sided colectomy and compression anastomosis with the CAR (TM) 27 device. Minor morbidities, 3 of 23 (13%) patients, included one small postoperative abscess requiring antibiotics alone and two postoperative anastomotic strictures requiring balloon dilation. Major morbidities, 1 of 23 (4%) patients, included a partial anastomotic dehiscence/leak requiring surgical dismantling of the anastomosis and diversion. The CAR (TM) 27 device shows promise as a safe and effective alternative for the creation of colorectal anastomoses. However, studies in a larger patient population are warranted to demonstrate equivalence of this device.