Stapled Antimesenteric Functional End-to-End Anastomosis Following Intestinal Resection for Crohn’s Disease

Abstract

BACKGROUND: 

Anastomotic recurrence after bowel resection is problematic in patients with Crohn’s disease. Antimesenteric functional end-to-end handsewn (Kono-S) anastomosis is associated with a low risk of anastomotic recurrence in patients with Crohn’s disease.

IMPACT OF INNOVATION: 

Kono-S anastomosis is effective but may be time-consuming. This study aimed to describe stapled antimesenteric functional end-to-end anastomosis for patients with Crohn’s disease.

TECHNOLOGY MATERIALS AND METHODS: 

The mesentery of the affected bowel segment was divided. A 5-cm-wide stapled functional end-to-end anastomosis was performed approximately 6 cm from the affected segment. The bowel was divided transversely exactly 90° to the intestinal lumen and the mesentery, and a supporting column was then constructed.

PRELIMINARY RESULTS: 

From January 2018 to June 2021, 17 stapled antimesenteric functional end-to-end anastomoses were performed. The mean operative time was 106 (range, 80–135) minutes, and the time to construct the stapled antimesenteric functional end-to-end anastomosis was 21 (range, 18–28) minutes. The mean follow-up time was 8.9 (range, 1–15) months. In total, 10 patients underwent surveillance endoscopy. The average Rutgeerts score was 0.8 (range, 0–4), and the incidence of endoscopic recurrence was 11.8%. No postoperative mortality or anastomotic leakage was observed.

CONCLUSION: 

Stapled antimesenteric functional end-to-end anastomosis may be a safe and time-saving procedure for patients with Crohn’s disease.

FUTURE DIRECTIONS: 

Further prospective studies with a large sample size are warranted.