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01-02-2019 | Original Article

Surgical Recurrence at Anastomotic Site After Bowel Resection in Crohn’s Disease: Comparison of Kono-S and End-to-end Anastomosis

Authors: Norimitsu Shimada, Hiroki Ohge, Toru Kono, Ayumu Sugitani, Raita Yano, Yusuke Watadani, Kenichiro Uemura, Yoshiaki Murakami, Taijiro Sueda

Published in: Journal of Gastrointestinal Surgery | Issue 2/2019

Abstract

Background

Anastomotic surgical recurrence after bowel resection in Crohn’s disease patients is problematic. This study was performed to evaluate the increased risk of anastomotic surgical recurrence.

Methods

From 2006 to 2016, we performed anastomoses in 215 consecutive Crohn’s disease patients. The cohort was divided into two groups: Kono-S anastomosis (n = 117) and end-to-end anastomosis (n = 98). Multivariate analysis of predictors of anastomotic surgical recurrence and Kaplan–Meier analysis for the 5-year anastomotic surgical recurrence rate were evaluated.

Results

The two groups showed no statistically significant differences in patient backgrounds. During a median follow-up of 54 months, 28 patients required anastomotic surgical recurrence [4 (3.4%) in the Kono-S group and 24 (24.4%) in the end-to-end group]. Six leaks (5.1%) were detected in the Kono-S group and 17 leaks (17.3%) in the end-to-end group; all were successfully treated conservatively. End-to-end anastomosis, leakage, age < 45 years, and body mass index of ≥ 18 kg/m² at the first surgery had a higher risk of anastomotic surgical recurrence. Kono-S anastomosis significantly reduced the risk of anastomotic surgical recurrence after 1 year (odds ratio, 0.14). Anastomotic leakage influenced anastomotic surgical recurrence within 1 year (odds ratio, 4.84). The 5-year surgery-free survival rate at the anastomosis site with Kono-S anastomosis (95.0%) was significantly higher than that with end-to-end anastomosis (81.3%; P < 0.001).

Conclusions

Anastomotic leakage after bowel resection in Crohn’s disease patients increased anastomotic surgical recurrence within 1 year, and Kono-S anastomosis is associated with a low risk of anastomotic surgical recurrence after > 1 year.

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Title: Surgical Recurrence at Anastomotic Site After Bowel Resection in Crohn’s Disease: Comparison of Kono-S and End-to-end Anastomosis
Authors: Norimitsu Shimada
Hiroki Ohge
Toru Kono
Ayumu Sugitani
Raita Yano
Yusuke Watadani
Kenichiro Uemura
Yoshiaki Murakami
Taijiro Sueda
Publication date: 01-02-2019
Publisher: Springer US
Published in: Journal of Gastrointestinal Surgery / Issue 2/2019
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI: https://doi.org/10.1007/s11605-018-4012-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Surgical Recurrence at Anastomotic Site After Bowel Resection in Crohn’s Disease: Comparison of Kono-S and End-to-end Anastomosis

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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