Safety & feasibility of targeted mesenteric approaches with Kono-S anastomosis and extended mesenteric excision in ileocolic resection and anastomosis in Crohn's disease.
Crohn's disease
Extended mesenteric excision
Inflammation
Kono-S anastomosis
Recurrence
Journal
American journal of surgery
ISSN: 1879-1883
Titre abrégé: Am J Surg
Pays: United States
ID NLM: 0370473
Informations de publication
Date de publication:
Apr 2024
Apr 2024
Historique:
received:
11
08
2023
revised:
22
10
2023
accepted:
24
10
2023
pubmed:
2
11
2023
medline:
2
11
2023
entrez:
1
11
2023
Statut:
ppublish
Résumé
The mesentery has recently been implicated in the pathophysiology of Crohn's disease (CD), and several techniques have been developed to target the mesentery to reduce its influence on recurrence. We aimed to describe short-term safety and feasibility after these approaches. This is a comparative, retrospective, single-center cohort study of consecutive CD patients undergoing primary or redo ileocolic resection from 2015 to 2022 with Kono-S anastomosis (KSA), extended mesenteric excision (EME) only, or both: mesenteric excision and exclusion (MEE). 186 patients underwent KSA (n = 74), EME (n = 66), or MEE (n = 46). The groups had comparable baseline characteristics. The MEE group operative time was longer (median: 187 vs. KSA 170, EME 152 min, p < 0.01). Postoperatively, the groups had similar lengths of stay (median 4 days), readmissions (9.1 %), major postoperative complications (6.5 %), and anastomotic leaks (1.1 %). Targeting the mesentery with novel surgical approaches for ileocolic Crohn's disease was safe and feasible for short-term follow-up.
Sections du résumé
BACKGROUND
BACKGROUND
The mesentery has recently been implicated in the pathophysiology of Crohn's disease (CD), and several techniques have been developed to target the mesentery to reduce its influence on recurrence. We aimed to describe short-term safety and feasibility after these approaches.
METHODS
METHODS
This is a comparative, retrospective, single-center cohort study of consecutive CD patients undergoing primary or redo ileocolic resection from 2015 to 2022 with Kono-S anastomosis (KSA), extended mesenteric excision (EME) only, or both: mesenteric excision and exclusion (MEE).
RESULTS
RESULTS
186 patients underwent KSA (n = 74), EME (n = 66), or MEE (n = 46). The groups had comparable baseline characteristics. The MEE group operative time was longer (median: 187 vs. KSA 170, EME 152 min, p < 0.01). Postoperatively, the groups had similar lengths of stay (median 4 days), readmissions (9.1 %), major postoperative complications (6.5 %), and anastomotic leaks (1.1 %).
CONCLUSION
CONCLUSIONS
Targeting the mesentery with novel surgical approaches for ileocolic Crohn's disease was safe and feasible for short-term follow-up.
Identifiants
pubmed: 37914660
pii: S0002-9610(23)00578-0
doi: 10.1016/j.amjsurg.2023.10.050
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
16-20Informations de copyright
Copyright © 2023 Elsevier Inc. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of competing interest SDH: consulting fees, Takeda USA; research funding, Crohn's & Colitis Foundation; American Society of Colon and Rectal Surgery. The remaining authors have no disclosures.