Academic Journal
Long-term Outcome of the Kono-S Anastomosis: A Multicenter Study
| العنوان: | Long-term Outcome of the Kono-S Anastomosis: A Multicenter Study |
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| المؤلفون: | Fichera, Alessandro, Mangrola, Anjali, Olortegui, Kinga S, Rebollo, Daniela, Stringfield, Sarah, Kapadia, Muneera, Madduri, Supradeep S., Ogola, Gerald, Krane, Mukta |
| المصدر: | Diseases of the Colon & Rectum ; ISSN 0012-3706 |
| بيانات النشر: | Ovid Technologies (Wolters Kluwer Health) |
| سنة النشر: | 2023 |
| الوصف: | BACKGROUND: Postoperative recurrence remains a significant problem in Crohn’s disease, and the mesentery is implicated in the pathophysiology. The Kono-S anastomosis was designed to exclude the mesentery from a wide anastomotic lumen, limit luminal distortion and fecal stasis, and preserve innervation and vascularization. OBJECTIVE: To review postoperative complications and long-term outcomes of the Kono-S anastomosis in a large series of consecutive unselected patients with Crohn’s disease. DESIGN: Retrospective study of prospectively collected patients. SETTINGS: Four tertiary referral centers. PATIENTS: Consecutive patients with Crohn’s disease undergoing resection with Kono-S anastomosis between May 2010 and June 2022 INTERVENTIONS: Extracorporeal handsewn Kono-S anastomosis. MAIN OUTCOME MEASURES: Postoperative outcomes and recurrence defined as endoscopic, clinical, laboratory, or surgical including endoscopic intervention. RESULTS: A total of 262 consecutive patients (53.4% male) were included. Mean duration of disease at surgery was 145.1 months. One hundred thirty-five patients (51.5%) had previous abdominal surgery for Crohn’s disease. Forty-four patients (17%) were actively smoking and 150 (57.3%) were on biologic therapy. Anastomotic failure occurred in 4 (1.5%) with 2 patients requiring reoperation (0.7%). Sixteen patients had postoperative surgical site infection (6.1%). With a median follow-up of 49.4 months, 20 patients (7.6%) were found to have surgical recurrence. In the multivariate analysis, perianal disease (OR=2.83, p = 0.001), urgent/emergent surgery (OR=3.23, p = 0.007), postoperative use of steroids (OR=2.29, p = 0.025) were associated with increased risk of overall recurrence. LIMITATION: Retrospective study. Variability of perioperative medical therapy. CONCLUSIONS: Our study showed very low postoperative complication rates despite the complexity of the patient population. There was a low rate of surgical recurrence, likely due to the intrinsic advantages of the anastomotic ... |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| DOI: | 10.1097/dcr.0000000000003132 |
| DOI: | 10.1097/DCR.0000000000003132 |
| الاتاحة: | http://dx.doi.org/10.1097/dcr.0000000000003132 https://journals.lww.com/10.1097/DCR.0000000000003132 |
| رقم الانضمام: | edsbas.3FC1DFEB |
| قاعدة البيانات: | BASE |
| DOI: | 10.1097/dcr.0000000000003132 |
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