Crohn’s disease and postoperative recurrence. The role of anastomotic configurations and the kono-s anastomosis.


COD: 02_2019_04-2985 Categorie: ,

Rosario Fornaro, Giuseppe Caristo, Emanuela Stratta, Alba Oliva, Davide Giovinazzo, Matteo Mascherini, Marco Frascio

Ann. Ital. Chir., 2019 90, 2: 111-120

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BACKGROUND: The observation that in more than 90% of Crohn’s disease patients the postoperative recurrences are located in the pre-anastomotic tract leads us to suppose that the anastomosis would play a role in the appearance of recurrences.
AIM AND METHODS: To focus the role of different anastomotic configurations in the incidence of recurrences, the Authors have conducted a review of the literature of the last two decades and have revised critically their experience.
RESULTS: The rate of recurrences seem to be lower in patients in whom the anastomotic configuration is such as to present a wide lumen; it seems that they are lower after stapled side-to-side anastomosis. The Kono-S anastomosis, recently
introduced technique, seems to offer better results.
CONCLUSIONS: The role of the various types of anastomosis remains uncertain. Further large-scale controlled trials with long term follow-up are needed.