Experiences with the Kono-S Anastomosis in Crohn’s Disease of the Terminal Ileum—a Cohort Study
Autor: | Matthias Turina, Andreas Rickenbacher, D. L. Birrer, Karoline Horisberger |
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Přispěvatelé: | University of Zurich, Horisberger, K |
Jazyk: | angličtina |
Rok vydání: | 2021 |
Předmět: |
Crohn’s disease
medicine.medical_specialty medicine.medical_treatment 610 Medicine & health Anastomosis Kono-S anastomosis Cohort Studies Ileostomy Postoperative Complications Crohn Disease Ileum Recurrence medicine Humans Prospective Studies Retrospective Studies 10217 Clinic for Visceral and Transplantation Surgery Crohn's disease business.industry Anastomosis Surgical Endoscopic dilatation Terminal ileum Ileocecal resection medicine.disease Surgery Cardiac surgery 2746 Surgery Stenosis Cardiothoracic surgery Original Article business Abdominal surgery |
Zdroj: | Langenbeck's Archives of Surgery |
Popis: | Purpose The most frequent long-term complication after ileocecal resection in Crohn’s disease is anastomotic recurrence and subsequent stenosis. Recurrence typically begins at the site of the anastomosis, raising the question of whether the surgical technique of the anastomosis could affect recurrence rates. Kono-S anastomosis is a hand-sewn antimesenteric functional end-to-end anastomosis that offers a wide lumen that is well accessible for endoscopic dilatation. The purpose of our study is to review the rate of postoperative complications almost 2 years after the introduction of this technique. Materials and methods This is a prospective single-center cohort study of all consecutive patients with Crohn’s disease undergoing ileocecal resection. Patients’ characteristics as well as specific data for the surgical procedure and short-term outcome were evaluated. Results Thirty patients were operated for Crohn’s disease of the terminal ileum (n = 24) or anastomotic recurrence (n = 6). Postoperative complications with a Clavien-Dindo Score ≥ IIIb were observed in three patients. One patient showed a hemorrhage and underwent surgical hemostasis. Two patients developed anastomotic leakage; in both cases, ileostomy was created after resection of the anastomosis. The median hospital stay was 9 days (IQR 7–12). A comparison with a historic group of conventionally operated patients of our hospital revealed no differences in short-term results except for the duration of surgery. Conclusion The Kono-S anastomosis is associated with acceptable short-term results, complications, and recurrence rates comparable with the established anastomotic techniques. Longer operation times are observed, but the few published studies concerning long-term recurrence are promising. |
Databáze: | OpenAIRE |
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