Device for performing anastomosis

A kit of parts is provided for forming a device for performing anastomosis a first gastro-intestinal tract. The kit of parts comprises an inner ring, comprising an outer surface generally facing away from the passage, and an outer ring, comprising an inner surface. When the inner ring and the outer ring are in an assembled state, the inner ring is at least partially positioned in the reception volume of the outer ring, at least part of the outer surface of the inner ring faces towards the inner surface of the outer ring, and the outer surface and the inner surface together define an annular space between them, wherein at least part of the annular space diverges in the generally axial direction

Radiofrequency ablation is beneficial in simultaneous treatment of synchronous liver metastases and primary colorectal cancer

In patients with resectable synchronous colorectal liver metastases (CRLM), either two-staged or simultaneous resections of the primary tumor and liver metastases are performed. Data on radiofrequency ablation (RFA) for the treatment of CRLM during a simultaneous procedure is lacking. The primary aim was to analyze short-term and long-term outcome of RFA in simultaneous treatment. A secondary aim was to compare simultaneous resection with the colorectal-first approach.Retrospective analysis of 241 patients with colorectal cancer and synchronous CRLM between 2000-2016. Median follow-up was 36.1 months (IQR 18.2-58.8 months). A multivariable analysis was performed to analyze the postoperative morbidity, using the comprehensive complication index. A propensity matched analysis was performed to compare survival rates.In multivariable analysis, the best predictor of lower complication severity was treatment with RFA (p = 0.040). Higher complication rates were encountered in patients who underwent an abdominoperineal resection (p = 0.027) or age > 60 years (p = 0.022). The matched analysis showed comparable overall survival in RFA treated patients versus patients undergoing a liver resection with a five year overall survival of 39.4% and 37.5%, respectively (p = 0.782). In a second matched analysis, 5-year overall survival rates in simultaneously treated patients (43.8%) was comparable to patients undergoing the colorectal first approach (43.0%, p = 0.223).RFA treatment of CRLM in simultaneous procedures is associated with a lower complication severity and non-inferior oncological outcome as compared to partial liver resection. RFA should be considered a useful alternative to liver resection

The C-seal: A Biofragmentable Drain Protecting the Stapled Colorectal Anastomosis from Leakage

Colorectal anastomotic leakage (AL) is a serious complication in colorectal surgery leading to high morbidity and mortality rates1. The incidence of AL varies between 2.5 and 20% 2-5. Over the years, many strategies aimed at lowering the incidence of anastomotic leakage have been examined6, 7