The primary purpose of this prospective, randomized multicenter center study is to evaluate and compare the outcomes of colorectal and coloanal anastomoses reinforced with a bioabsorbable staple line reinforcement material compared with standard non-reinforced colorectal and coloanal techniques with respect to the incidence of postoperative anastomotic leakage, anastomotic stricture and time to ileostomy closure.

This is a randomized prospective trial that compares the use of GORE SEAMGUARD® Bioabsorbable Staple Line Reinforcement (CBSG) to standard stapling techniques in colorectal resections. The potential exists to utilize CBSG as a means of lowering the rate of post-operative anastomotic leakage and bleeding in high-risk colorectal and coloanal anastomoses.

Inclusion Criteria:

• Subjects who will undergo preoperative chemoradiation therapy in the treatment of their rectal cancer.
• Subjects who will have a diverting loop ileostomy as a component of their initial surgery for rectal cancer.
• Subjects that will undergo restorative proctectomy with a low circular stapled colorectal or coloanal anastomosis (<10cm from the anal verge) with or without reservoir.

Exclusion Criteria:

• Subjects with a diagnosis of inflammatory bowel disease.
• Subjects who have significant intraoperative hypotension or cardiac events.
• Subjects with collagen vascular disease, coagulopathy, significant renal or hepatic dysfunction (creatinine >1.6 or liver enzymes > 50% upper limit of normal values).