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Introduction <p>Ileocecal resection is the most common surgery in Crohn’s disease (CD). As recurrences often occur at the anastomosis it has been questioned whether surgical technique may have a role in its prevention. The Kono-S anastomosis, first described in 2011, has shown potential to reduce anastomotic recurrence while maintaining luminal width and preventing distortion. The classic surgery described was a handsewn anastomosis. Lately a stapled approach has emerged which is less technically demanding, and requires shorter operative time.</p> <p>We compared stapled versus handsewn Kono-S ileocolonic anastomosis in patients with Crohn’s disease, evaluating operative time and perioperative outcomes.</p> Methods <p>Data on all consecutive patients with CD aged ≥ 18&#xa0;years at a single tertiary center, who underwent ileocolonic resection by inflammatory bowel disease (IBD)-dedicated surgeons with Kono-S anastomosis from July 2023 to April 2025, were collected retrospectively.</p> Results <p>In total, 25 patients were included. Overall, 15 (60%) underwent handsewn anastomosis and 10 (40%) underwent stapled anastomosis. There were no clinical or demographic differences. Median operative time was shorter in the stapled group (151 versus 203&#xa0;min, <i>p</i> = 0.01). Postoperative complications occurred in 2/10 patients (20%) in the stapled group and 4/15 (26.7%) in the handsewn group (<i>p</i> = 0.70). One patient required reoperation in the handsewn group. Postoperative day 3 C-reactive protein (CRP) was lower in the stapled group (median 69 versus 165&#xa0;mg/L, <i>p</i> = 0.03). There was one case of 30-day rehospitalization in the stapled group.</p> Conclusions <p>The stapled Kono-S anastomosis technique is a shorter procedure with similar perioperative outcomes compared with the handsewn technique. Follow-up studies, with larger sample sizes, are required to evaluate long-term efficacy and disease recurrence rates.</p>

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Comparing perioperative outcomes of stapled versus handsewn Kono-S anastomosis after ileocolonic resection for Crohn’s disease

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  • 发表日期：

    2025年10月16日

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  • E. Benshabat,
  • J. B. Yuval,
  • H. Leibovitzh,
  • A. Hirsch,
  • G. Lahat,
  • Y. Kariv,
  • M. Zemel

摘要

Introduction

Ileocecal resection is the most common surgery in Crohn’s disease (CD). As recurrences often occur at the anastomosis it has been questioned whether surgical technique may have a role in its prevention. The Kono-S anastomosis, first described in 2011, has shown potential to reduce anastomotic recurrence while maintaining luminal width and preventing distortion. The classic surgery described was a handsewn anastomosis. Lately a stapled approach has emerged which is less technically demanding, and requires shorter operative time.

We compared stapled versus handsewn Kono-S ileocolonic anastomosis in patients with Crohn’s disease, evaluating operative time and perioperative outcomes.

Methods

Data on all consecutive patients with CD aged ≥ 18 years at a single tertiary center, who underwent ileocolonic resection by inflammatory bowel disease (IBD)-dedicated surgeons with Kono-S anastomosis from July 2023 to April 2025, were collected retrospectively.

Results

In total, 25 patients were included. Overall, 15 (60%) underwent handsewn anastomosis and 10 (40%) underwent stapled anastomosis. There were no clinical or demographic differences. Median operative time was shorter in the stapled group (151 versus 203 min, p = 0.01). Postoperative complications occurred in 2/10 patients (20%) in the stapled group and 4/15 (26.7%) in the handsewn group (p = 0.70). One patient required reoperation in the handsewn group. Postoperative day 3 C-reactive protein (CRP) was lower in the stapled group (median 69 versus 165 mg/L, p = 0.03). There was one case of 30-day rehospitalization in the stapled group.

Conclusions

The stapled Kono-S anastomosis technique is a shorter procedure with similar perioperative outcomes compared with the handsewn technique. Follow-up studies, with larger sample sizes, are required to evaluate long-term efficacy and disease recurrence rates.