A Rare Complication Following Anastomosis Suturing Using a Biofragmentable Valtrac© Anastomosis Ring – A Case Review and Literature Overview

Česká verzia

Authors: L. Lakyová; T. Toporcer; J. Bober; J. Radoňak
Authors place of work: I. chirurgická klinika, Lekárska fakulta Univerzity Pavla Jozefa Šafárika, Košice, Fakultná nemocnica ; L. Pasteura, Košice, Slovenská republika, prednosta kliniky: prof. MUDr. Jozef Radoňak, CSc.
Published in the journal: Rozhl. Chir., 2010, roč. 89, č. 7, s. 446-449.
Category: Monothematic special - Original

Summary

The use of Valtrac Ring since 1985 has brought about the ability of easier anastomosis suturing and shortening of the operative treatment. As other methods, also Valtrac ring has its disadvantages. Authors present a case report of a complication previously not described in the literature.

A 67 year old patient, after right hemicolectomy with ileotransversoanastomosis with the help of Valtrac due to adenocarcinoma, underwent a control colonoscopy six month after operation. Small polyps in colon sigmoideum , colon descendens and transverse were removed and a tissue stripe with ulceration was found during the examination. The bioptic sample was taken from this stripe. After the application of Fragmine, the patient had a massive enterorhagia, which was not even resolved by adrenaline per colonoscopy. The patient underwent re-resection of ileotrasversoanastomosis. A ring of tissue, created by circular necrosis in the place of seroserous connection of biofragmentile ring of both of the lumens, was found in the tissue sample.

Stenosis of the anastomosis, dehiscence, bleeding and fistulation are described in the literature as the most common complications after Valtrac use. The incidence is comparable with complications during anastomosis sutured by hand. We would like to bring this extremely rare complication to the attention to all surgeons and gastroenterologists, who perform endoscopic examinations in patients after this surgical procedure.

Key words:
Valtrac© – necrosis – bowel resection – bleeding

Zdroje

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