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(-)(+)(-)(-)(-)(-)(-)(-)(-)(-)(-)(-)(-)(-)(-)(-)(-)(-)(-)(-)(-)(-)(-)(-)(-)(+)(+)(+)B was aimed at addressing its safety for use in colorectal anastomosis.In approach A, the aim was to examine the utility by measurement of RIP. Results showed not statis-tical differences, although the mean RIP of the PGA group was higher than that of the nonPGA group. This finding showed that the PGA sheet might reduce the AL in colorectal surgery. Naito et al reported that the high rates of complete staple formation were important for reducing anastomosis failure16). They reported that reinforcement with the PGA sheet results in higher rates of complete staple formation in the approach of linear-staple on linear-staple site. In this animal model, there might be the same reinforcement with the PGA sheet in circular-staple on linear-staple site.In approach B, laparoscopic AR was performed to clinically and histologically assess the safety of short-term outcomes of DST anastomosis postop-PGAControl caseCase 1Case 2Case 3The mean RIP was 9.28 kPa for the PGA group versus 5.78 kPa for the nonPGA group, which did not reach statistical significance (p = 0.3913).Clinical complications of anastomosisleakagebleedingFigure 4　Measurement of RIPTable 1　Result of Approach Bstructureeratively. This evaluation showed that the PGA sheet may be safe for use in colorectal surgery. Of the three pigs examined, none was found to have complications from the anastomosis. Histologic find-ings showed the PGA sheet remained in the anas-tomosis and that granulation formation had occurred around the anastomosis because of using the PGA sheet because the sheet provided scaffolds for early tissue repair. Well-built barriers of inflammatory granulation developed around the site of the anas-tomosis. Takagi et al showed this scaffold reduced the postoperative rate of pancreatic fistula12). Early enclosure of the pancreatic leak by the granulation formation may have been achieved, and the barrier formed by the abundant fibroblast infiltration in the scaffold of the PGA sheet likely prevented the postoperative pancreatic fistula.This study has several limitations. First, the sample size was small and thus could not demon-Histological findings in anastomotic tissueleakageNecrotic tissueAbscess formation477