Kono-S Anastomosis for Surgical Prophylaxis of Anastomotic Recurrence in Crohn's Disease: an International Multicenter Study

被引:105
作者
Kono, Toru [1 ]
Fichera, Alessandro [2 ]
Maeda, Koutarou [3 ]
Sakai, Yoshiharu [4 ]
Ohge, Hiroki [5 ]
Krane, Mukta [2 ]
Katsuno, Hidetoshi [3 ]
Fujiya, Mikihiro [6 ]
机构
[1] Sapporo Higashi Tokushukai Hosp, Adv Surg Ctr, Higashi Ku, 3-1,N 33,E 14, Sapporo, Hokkaido 0650033, Japan
[2] Univ Washington, Med Ctr, Dept Surg, Div Gen Surg, Seattle, WA 98195 USA
[3] Fujita Hlth Univ, Sch Med, Dept Surg, Toyoake, Aichi 47011, Japan
[4] Kyoto Univ, Dept Surg, Grad Sch Med, Kyoto, Japan
[5] Hiroshima Univ Hosp, Dept Infect Dis, Hiroshima, Japan
[6] Asahikawa Med Univ, Dept Med, Div Gastroenterol & Hematol Oncol, Asahikawa, Hokkaido, Japan
关键词
Crohn's disease; Kono-S anastomosis; Surgical recurrence; POSTOPERATIVE RECURRENCE; BLOOD-FLOW; PREVENTION; RESECTION; HANDSEWN; SURGERY; METAANALYSIS;
D O I
10.1007/s11605-015-3061-3
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
The Kono-S (antimesenteric functional end-to-end handsewn) anastomosis has been used for Crohn's disease in Japan and the USA since 2003 and 2010, respectively. This technique was designed to reduce the risk of anastomotic surgical recurrence. This study reviews the outcomes a decade after the introduction of the Kono-S anastomosis to clinical practice. This study was conducted at five hospitals (four in Japan and one in the USA). A total of 187 patients in Japan (144 patients, group J) and the USA (43 patients, group US) who underwent Kono-S anastomosis for Crohn's disease between September 2003 and September 2011 were included. With a median follow-up of 65 months, two surgical anastomotic recurrences have occurred in group J. Kaplan-Meier analysis showed that 5 and 10 years surgical recurrence-free survival rate was 98.6 % in group J. No surgical anastomotic recurrences have been detected in group US with a median follow-up of 32 months. The Kono-S anastomosis was technically feasible and performed in all patients. The Kono-S anastomosis appears to be safe and effective in reducing the risk of surgical recurrence in Crohn's disease.
引用
收藏
页码:783 / 790
页数:8
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