Novel antimesenteric functional end-to-end handsewn (kono-s) anastomoses for crohn's disease: A report of surgical procedure and short-term outcomes

Hidetoshi Katsuno, Koutarou Maeda, Tsunekazu Hanai, Koji Masumori, Yoshikazu Koide, Toru Kono

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Introduction: Anastomotic surgical recurrence after bowel resection is a major problem in patients with Crohn's disease. The aim of this prospective observational study was to evaluate the efficacy of a novel technique for restoring bowel continuity after resection involving either the small or the large intestine. Methods: The first case was instructed by Dr. Kono at Fujita Health University. The involved bowel segment was divided transversely with a linear stapler. The edges of two stapled lines are then connected to create a supporting column, which prevented surgical recurrence from anastomotic distortion due to mesenteric longitudinal ulcers. Thereafter, an antimesenteric longitudinal enterotomy was performed on each side to create a large-sized handsewn end-to-end anastomosis. Results: Thirty consecutive patients underwent Kono-S anastomoses from December 2009 to August 2013. Neither anastomotic leakage nor surgical recurrence was observed during a median follow-up period of 35 months. Endoscopic surveillance was performed in 18 cases (69.2%) undergoing ileo-colonic or ileo-rectal anastomosis with an average Rutgeert's score of 0.78 (0-3) at a mean of 14.5 months postoperatively. Conclusion: The Kono-S anastomosis for Crohn's disease has been a safe and feasible technique. Long-term outcomes are required to confirm its advantage in preventing surgical recurrence at the anastomosis.

Original languageEnglish
Pages (from-to)39-44
Number of pages6
JournalDigestive Surgery
Volume32
Issue number1
DOIs
Publication statusPublished - 24-03-2015

All Science Journal Classification (ASJC) codes

  • Surgery
  • Gastroenterology

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