Impact of different anastomosis methods on post-recurrence after intestinal resection for Crohn's disease: A meta-analysis

被引:1
作者
Wang, Zheng-Zuo [1 ]
Zhao, Chun-Hua [2 ]
Shen, Hui [3 ]
Dai, Gui-Ping [4 ]
机构
[1] Jiashan Hosp Tradit Chinese Med, Dept Anorectal, Jiaxing 314100, Zhejiang, Peoples R China
[2] Jiashan Hosp Tradit Chinese Med, Dept Oncol, Jiaxing 314100, Zhejiang, Peoples R China
[3] Jiashan Hosp Tradit Chinese Med, Dept Gastroenterol, 38 Gujiadai, Jiaxing 314100, Zhejiang, Peoples R China
[4] Second Hosp Jiaxing, Dept Oncol, Jiaxing 314000, Zhejiang, Peoples R China
来源
WORLD JOURNAL OF GASTROINTESTINAL SURGERY | 2024年 / 16卷 / 04期
关键词
Kono-S; Crohn's disease; Traditional anastomosis; Postoperative recurrence; Meta-analysis; SURGICAL PREVENTION;
D O I
10.4240/wjgs.v16.i4.1165
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
BACKGROUND Crohn's disease (CD) is a chronic inflammatory disease of the gastrointestinal tract, often requiring intestinal resection as a common treatment. However, recurrence after surgery is common. The anastomotic configuration after bowel resection appears to be associated with the recurrence of CD. Previous studies have suggested that the Kono-S anastomosis may help to reduce the recurrence rate. However, the results remain controversial. Therefore, evidence-based evidence is needed to prove the advantages of Kono-S anastomosis. AIM To measure the influence of anastomosis techniques on the long-term relapse rate of CD by conducting a meta-analysis. METHODS PubMed, Scopus, and Cochrane Library were searched until October 8, 2023. Patients who underwent intestinal resection due to CD were included. The intervention measures included Kono-S anastomosis, whereas the control group received traditional anastomosis such as end-to-end, end-to-side, and side-to-side anastomosis. Only randomized clinical trials and observational studies were included. The primary outcome measures were hospital stay post-surgery, overall postoperative complication incidence, the proportion of Clavien-Dindo grade IIIa or higher, overall postoperative recurrence rate, and Rutgeerts score. RESULTS From 2011 to 2023, six articles met the inclusion and exclusion criteria. The results indicated that Kono-S anastomosis can reduce the hospital stay post-surgery of patients with CD [MD = -0.26, 95%CI: -0.42 to -0.10, P = 0.002] than other traditional anastomosis methods. Compared to other traditional anastomosis methods, Kono-S anastomosis can significantly reduce the total recurrence rate [MD = 0.40, 95%CI: 0.17 to 0.98, P = 0.05] and postoperative Rutgeerts score [MD = -0.81, 95%CI: -0.96 to -0.66, P < 0.001] in patients with CD. However, there is no significant disparity in the overall occurrence of postoperative complications and the proportion of Clavien-Dindo >= IIIa. CONCLUSION Kono-S anastomosis has the potential to expedite the recuperation of CD and diminish relapse hazards; however, additional larger trials are necessary to authenticate its effectiveness.
引用
收藏
页数:12
相关论文
共 32 条
[1]   Does Kono-S Anastomosis Reduce Recurrence in Crohn's Disease Compared with Conventional Ileocolonic Anastomosis? A Nationwide Propensity Score-matched Study from GETAID Chirurgie Group [KoCoRICCO Study] [J].
Alibert, Line ;
Betton, Louis ;
Falcoz, Antoine ;
Manceau, Gilles ;
Benoist, Stephane ;
Zerbib, Philippe ;
Podevin, Juliette ;
Maggiori, Leon ;
Brouquet, Antoine ;
Tyrode, Gaelle ;
Vuitton, Lucine ;
Vernerey, Dewi ;
Lefevre, Jeremie H. ;
Lakkis, Zaher .
JOURNAL OF CROHNS & COLITIS, 2024, 18 (04) :525-532
[2]   Crohn's disease [J].
Ballester Ferre, Maria Pilar ;
Maia Bosca-Watts, Marta ;
Minguez Perez, Miguel .
MEDICINA CLINICA, 2018, 151 (01) :26-33
[3]   Postoperative Crohn's disease management [J].
Barnes, Edward L. .
CURRENT OPINION IN GASTROENTEROLOGY, 2020, 36 (04) :277-283
[4]   Totally stapled Kono-S anastomosis for Crohn's disease [J].
Bislenghi, G. ;
Devriendt, S. ;
Wolthuis, A. ;
D'Hoore, A. .
TECHNIQUES IN COLOPROCTOLOGY, 2022, 26 (03) :213-216
[5]   Time for an Australian and New Zealand randomized controlled trial to study the modified Kono S anastomosis [J].
Clark, David A. A. ;
Smith, Nicholas ;
Clark, Imogen ;
Giddings, Hugh ;
Rajan, Ruben .
ANZ JOURNAL OF SURGERY, 2022, 92 (12) :3132-3134
[6]  
Cottone Mario, 2009, Expert Rev Gastroenterol Hepatol, V3, P231, DOI 10.1586/egh.09.13
[7]   What's New in the Postoperative Management of Crohn's Disease? [J].
Dasharathy, Sonya S. ;
Limketkai, Berkeley N. ;
Sauk, Jenny S. .
DIGESTIVE DISEASES AND SCIENCES, 2022, 67 (08) :3508-3517
[8]   Antimesenteric Functional End-to-End Handsewn (Kono-S) Anastomosis [J].
Fichera, Alessandro ;
Zoccali, Marco ;
Kono, Toru .
JOURNAL OF GASTROINTESTINAL SURGERY, 2012, 16 (07) :1412-1416
[9]  
Fornaro R, 2019, ANN ITAL CHIR, V90, P111
[10]   Natural history and long-term clinical course of Crohn's disease [J].
Freeman, Hugh James .
WORLD JOURNAL OF GASTROENTEROLOGY, 2014, 20 (01) :31-36