Kono-S anastomosis in Crohn's disease: initial experience in pediatric patients.
Crohn’s disease
Endoscopy
Kono-S
Pediatric surgery
Postoperative complication
Journal
Pediatric surgery international
ISSN: 1437-9813
Titre abrégé: Pediatr Surg Int
Pays: Germany
ID NLM: 8609169
Informations de publication
Date de publication:
05 Mar 2024
05 Mar 2024
Historique:
accepted:
30
01
2024
medline:
5
3
2024
pubmed:
5
3
2024
entrez:
4
3
2024
Statut:
epublish
Résumé
Children diagnosed with Crohn's disease (CD) often undergo ileocecal resection (ICR) during childhood. Anastomotic recurrence is a frequent finding following this procedure. Data addressing the effect of the anastomosis type on disease recurrence are scarce in the pediatric population. The Kono-S anastomosis has shown promise in reducing endoscopic, clinical, and surgical recurrence rates in adults. We aimed to report our experience with Kono-S anastomosis in children, focusing on its feasibility and postoperative complications. We retrospectively analyzed pediatric CD patients who underwent ICR with Kono-S anastomosis between August 2022 and May 2023. Data on demographics, clinical characteristics, surgery, hospitalization, and follow-up including colonoscopy were collected. Complications were classified using the Clavien-Dindo classification. Twelve patients (7 females, 58.3%) were included. Six (50%) of the patients had the B3 luminal form of the disease (according to Paris classification). Median surgery duration was 174 (interquartile range [IQR] 161-216) minutes. Anastomosis creation took a median of 62 (IQR, 54.5-71) minutes. Median hospitalization length was 6 (IQR 4-7) days. No short- or mid-term complications were observed. Median follow-up duration was 9.5 (IQR 6.8-12) months. According to our results, Kono-S anastomosis is safe and feasible in pediatric CD patients, with no observed postoperative complications. These findings support the potential benefit of using Kono-S anastomosis as a treatment approach in children with CD.
Identifiants
pubmed: 38438752
doi: 10.1007/s00383-024-05648-6
pii: 10.1007/s00383-024-05648-6
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
67Informations de copyright
© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
Références
Sykora J, Pomahacova R, Kreslova M et al (2018) Current global trends in the incidence of pediatric-onset inflammatory bowel disease. World J Gastroenterol 24(25):2741–2763. https://doi.org/10.3748/wjg.v24.i25.2741
doi: 10.3748/wjg.v24.i25.2741
pubmed: 29991879
pmcid: 6034144
Gasparetto M, Guariso G (2013) Highlights in IBD epidemiology and its natural history in the paediatric age. Gastroenterol Res Pract 2013:829040. https://doi.org/10.1155/2013/829040
doi: 10.1155/2013/829040
pubmed: 24454343
pmcid: 3884601
de Bie CI, Paerregaard A, Kolacek S, Ruemmele FM, Koletzko S, Fell JM, Escher JC (2013) EUROKIDS Porto IBD Working Group of ESPGHAN Disease phenotype at diagnosis in pediatric Crohn’s disease: 5-year analyses of the EUROKIDS registry. Inflamm Bowel Dis 19(2):378–385. https://doi.org/10.1002/ibd.23008
doi: 10.1002/ibd.23008
pubmed: 22573581
Vernier-Massouille G, Balde M, Salleron J, Turck D, Dupas JL, Mouterde O, Merle V, Salomez JL, Branche J, Marti R, Lerebours E, Cortot A, Gower-Rousseau C, Colombel JF (2008) Natural history of pediatric Crohn’s disease: a population-based cohort study. Gastroenterology 135(4):1106–1113. https://doi.org/10.1053/j.gastro.2008.06.079
doi: 10.1053/j.gastro.2008.06.079
pubmed: 18692056
Splawski JB, Pffefferkorn MD, Schaefer ME et al (2017) NASPGHAN clinical report on postoperative recurrence in pediatric Crohn disease. J Pediatr Gastroenterol Nutr 65(4):475–486. https://doi.org/10.1097/MPG.0000000000001606
doi: 10.1097/MPG.0000000000001606
pubmed: 28937552
Stewart D (2017) Surgical care of the pediatric Crohn’s disease patient. Semin Pediatr Surg 26(6):373–378. https://doi.org/10.1053/j.sempedsurg.2017.10.007
doi: 10.1053/j.sempedsurg.2017.10.007
pubmed: 29126506
Zarubova K, Hradsky O, Copova I et al (2017) Endoscopic recurrence 6 months after ileocecal resection in children with Crohn disease treated with azathioprine. J Pediatr Gastroenterol Nutr 65(2):207–211. https://doi.org/10.1097/MPG.0000000000001470
doi: 10.1097/MPG.0000000000001470
pubmed: 28248209
Spencer EA, Jarchin L, Rolfes P, Khaitov S, Greenstein A, Dubinsky MC (2021) Outcomes of primary ileocolic resection for pediatric Crohn disease in the biologic era. J Pediatr Gastroenterol Nutr 73(6):710–716. https://doi.org/10.1097/MPG.0000000000003241
doi: 10.1097/MPG.0000000000003241
pubmed: 34292216
pmcid: 8604760
Egberg MD, Zhang X, Phillips M, Kappelman MD (2023) Trends in surgical recurrence among pediatric crohn’s disease patients using administrative claims data. Crohns Colitis 5(1):otad003. https://doi.org/10.1093/crocol/otad003
doi: 10.1093/crocol/otad003
Weigl E, Schwerd T, Lurz E, Häberle B, Koletzko S, Hubertus J (2023) Children with localized Crohn’s disease benefit from early ileocecal resection and perioperative anti-tumor necrosis factor therapy [published online ahead of print, 2023 Mar 16]. Eur J Pediatr Surg. https://doi.org/10.1055/s-0043-1764320
doi: 10.1055/s-0043-1764320
pubmed: 36929126
Diederen K, de Ridder L, van Rheenen P et al (2017) Complications and disease recurrence after primary ileocecal resection in pediatric Crohn’s disease: a multicenter cohort analysis. Inflamm Bowel Dis 23(2):272–282. https://doi.org/10.1097/MIB.0000000000000999
doi: 10.1097/MIB.0000000000000999
pubmed: 28079626
Hansen LF, Jakobsen C, Paerregaard A, Qvist N, Wewer V (2015) Surgery and postoperative recurrence in children with Crohn disease. J Pediatr Gastroenterol Nutr 60(3):347–351. https://doi.org/10.1097/MPG.0000000000000616
doi: 10.1097/MPG.0000000000000616
pubmed: 25373863
Kono T, Ashida T, Ebisawa Y et al (2011) A new antimesenteric functional end-to-end handsewn anastomosis: surgical prevention of anastomotic recurrence in Crohn’s disease. Dis Colon Rectum 54(5):586–592. https://doi.org/10.1007/DCR.0b013e318208b90f
doi: 10.1007/DCR.0b013e318208b90f
pubmed: 21471760
Kono T, Fichera A, Maeda K et al (2016) Kono-S anastomosis for surgical prophylaxis of anastomotic recurrence in Crohn’s disease: an International Multicenter Study. J Gastrointest Surg 20(4):783–790. https://doi.org/10.1007/s11605-015-3061-3
doi: 10.1007/s11605-015-3061-3
pubmed: 26696531
Luglio G, Rispo A, Imperatore N et al (2020) Surgical prevention of anastomotic recurrence by excluding mesentery in Crohn’s disease: the SuPREMe-CD study—a randomized clinical trial. Ann Surg 272(2):210–217. https://doi.org/10.1097/SLA.0000000000003821
doi: 10.1097/SLA.0000000000003821
pubmed: 32675483
Kelm M, Reibetanz J, Kim M et al (2022) Kono-S anastomosis in Crohn’s disease: a retrospective study on postoperative morbidity and disease recurrence in comparison to the conventional side-to-side anastomosis. J Clin Med 11(23):6915. https://doi.org/10.3390/jcm11236915
doi: 10.3390/jcm11236915
pubmed: 36498490
pmcid: 9739288
Alshantti A, Hind D, Hancock L, Brown SR (2021) The role of Kono-S anastomosis and mesenteric resection in reducing recurrence after surgery for Crohn’s disease: a systematic review. Colorectal Dis 23(1):7–17. https://doi.org/10.1111/codi.15136
doi: 10.1111/codi.15136
pubmed: 32418300
Levine A, Koletzko S, Turner D et al (2014) The ESPGHAN revised Porto criteria for the diagnosis of inflammatory bowel disease in children and adolescents. J Pediatr Gastroenterol Nutr 58(06):795–806. https://doi.org/10.1097/MPG.0000000000000239
doi: 10.1097/MPG.0000000000000239
pubmed: 24231644
Ruemmele FM, Veres G, Kolho KL, European Crohn’s and Colitis Organisation; European Society of Pediatric Gastroenterology, Hepatology and Nutrition et al (2014) Consensus guidelines of ECCO/ESPGHAN on the medical management of pediatric Crohn’s disease. J Crohns Colitis 8(10):1179–1207. https://doi.org/10.1016/j.crohns.2014.04.005
doi: 10.1016/j.crohns.2014.04.005
pubmed: 24909831
van Rheenen PF, Aloi M, Assa A et al (2020) The medical management of paediatric Crohn’s disease: an ECCO-ESPGHAN guideline update. J Crohns Colitis. https://doi.org/10.1093/ecco-jcc/jjaa161
doi: 10.1093/ecco-jcc/jjaa161
pubmed: 33026087
Amil-Dias J, Kolacek S, Turner D et al (2017) Surgical management of Crohn disease in children: guidelines from the Paediatric IBD Porto Group of ESPGHAN. J Pediatr Gastroenterol Nutr 64(5):818–835. https://doi.org/10.1097/MPG.0000000000001562
doi: 10.1097/MPG.0000000000001562
pubmed: 28267075
Adamina M, Bonovas S, Raine T et al (2020) ECCO guidelines on therapeutics in Crohn’s disease: surgical treatment. J Crohns Colitis 14(2):155–168. https://doi.org/10.1093/ecco-jcc/jjz187
doi: 10.1093/ecco-jcc/jjz187
pubmed: 31742338
Levine A, Griffiths A, Markowitz J et al (2011) Pediatric modification of the Montreal classification for inflammatory bowel disease: the Paris classification. Inflamm Bowel Dis 17(6):1314–1321. https://doi.org/10.1002/ibd.21493
doi: 10.1002/ibd.21493
pubmed: 21560194
Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240(2):205–213. https://doi.org/10.1097/01.sla.0000133083.54934.ae
doi: 10.1097/01.sla.0000133083.54934.ae
pubmed: 15273542
pmcid: 1360123
Rutgeerts P, Geboes K, Vantrappen G, Beyls J, Kerremans R, Hiele M (1990) Predictability of the postoperative course of Crohn’s disease. Gastroenterology 99(4):956–963. https://doi.org/10.1016/0016-5085(90)90613-6
doi: 10.1016/0016-5085(90)90613-6
pubmed: 2394349
Blackburn SC, Wiskin AE, Barnes C et al (2014) Surgery for children with Crohn’s disease: indications, complications and outcome. Arch Dis Child 99(5):420–426. https://doi.org/10.1136/archdischild-2013-305214
doi: 10.1136/archdischild-2013-305214
pubmed: 24395646
Feng JS, Li JY, Yang Z, Chen XY, Mo JJ, Li SH (2018) Stapled side-to-side anastomosis might be benefit in intestinal resection for Crohn’s disease: a systematic review and network meta-analysis. Medicine (Baltimore) 97(15):e0315. https://doi.org/10.1097/MD.0000000000010315
doi: 10.1097/MD.0000000000010315
pubmed: 29642162
Luglio G, Kono T (2021) Surgical techniques and risk of postoperative recurrence in CD: a game changer? Inflamm Intest Dis. 7(1):21–27. https://doi.org/10.1159/000515372
doi: 10.1159/000515372
pubmed: 35224014
pmcid: 8820132
Click B, Merchea A, Colibaseanu DT, Regueiro M, Farraye FA, Stocchi L (2022) Ileocolic resection for Crohn disease: the influence of different surgical techniques on perioperative outcomes, recurrence rates, and endoscopic surveillance. Inflamm Bowel Dis 28(2):289–298. https://doi.org/10.1093/ibd/izab081
doi: 10.1093/ibd/izab081
pubmed: 33988234
Dotlacil V, Lerchova T, Coufal S et al (2023) Comparison of laparoscopic and open ileocecal resection for Crohn’s disease in children. Pediatr Surg Int 39(1):140. https://doi.org/10.1007/s00383-023-05419-9
doi: 10.1007/s00383-023-05419-9
pubmed: 36847848
pmcid: 9971069
Quiroz HJ, Perez EA, El Tawil RA et al (2020) Open versus laparoscopic right hemicolectomies in pediatric patients with Crohn’s disease. J Laparoendosc Adv Surg Tech A 30(7):820–825. https://doi.org/10.1089/lap.2019.0814
doi: 10.1089/lap.2019.0814
pubmed: 32301642
Glenisson M, Bonnard A, Berrebi D, Belarbi N, Viala J, Martinez-Vinson C (2023) Complications and disease recurrence after ileocecal resection in pediatric Crohn’s disease: a retrospective study [published online ahead of print, 2023 Apr 11]. Eur J Pediatr Surg. https://doi.org/10.1055/a-2048-7407
doi: 10.1055/a-2048-7407
pubmed: 36882155
Peyrin-Biroulet L, Harmsen WS, Tremaine WJ, Zinsmeister AR, Sandborn WJ, Loftus EV Jr (2012) Surgery in a population-based cohort of Crohn’s disease from Olmsted County, Minnesota (1970–2004). Am J Gastroenterol 107(11):1693–1701. https://doi.org/10.1038/ajg.2012.298
doi: 10.1038/ajg.2012.298
pubmed: 22945286
pmcid: 3572861
Yao JY, Jiang Y, Ke J, Lu Y, Hu J, Zhi M (2020) Development of a prognostic model for one-year surgery risk in Crohn’s disease patients: a retrospective study. World J Gastroenterol 26(5):524–534. https://doi.org/10.3748/wjg.v26.i5.524
doi: 10.3748/wjg.v26.i5.524
pubmed: 32089628
pmcid: 7015715
Bislenghi G, Vancoillie PJ, Fieuws S et al (2023) Effect of anastomotic configuration on Crohn’s disease recurrence after primary ileocolic resection: a comparative monocentric study of end-to-end versus side-to-side anastomosis [published online ahead of print, 2023 Jun 12]. Updates Surg. https://doi.org/10.1007/s13304-023-01561-0
doi: 10.1007/s13304-023-01561-0
pubmed: 37943493
Wolford DD, Fichera A (2020) Prophylaxis of Crohn’s disease recurrence: a surgeon’s perspective. Ann Gastroenterol Surg. 4(5):514–520. https://doi.org/10.1002/ags3.12368
doi: 10.1002/ags3.12368
pubmed: 33005846
pmcid: 7511563
McLeod RS, Wolff BG, Ross S, Parkes R, McKenzie M, Investigators of the CAST Trial (2009) Recurrence of Crohn’s disease after ileocolic resection is not affected by anastomotic type: results of a multicenter, randomized, controlled trial. Dis Colon Rectum 52(5):919–927. https://doi.org/10.1007/DCR.0b013e3181a4fa58
doi: 10.1007/DCR.0b013e3181a4fa58
pubmed: 19502857
Shimada N, Ohge H, Kono T et al (2019) Surgical recurrence at anastomotic site after bowel resection in Crohn’s disease: comparison of Kono-S and end-to-end anastomosis. J Gastrointest Surg 23(2):312–319. https://doi.org/10.1007/s11605-018-4012-6
doi: 10.1007/s11605-018-4012-6
pubmed: 30353491
Ng CH, Chin YH, Lin SY et al (2021) Kono-S anastomosis for Crohn’s disease: a systemic review, meta-analysis, and meta-regression. Surg Today 51(4):493–501. https://doi.org/10.1007/s00595-020-02130-3
doi: 10.1007/s00595-020-02130-3
pubmed: 32894346
Bislenghi G, Devriendt S, Wolthuis A, D’Hoore A (2022) Totally stapled Kono-S anastomosis for Crohn’s disease. Tech Coloproctol 26(3):213–216. https://doi.org/10.1007/s10151-021-02551-3
doi: 10.1007/s10151-021-02551-3
pubmed: 35088189
Duan M, Wu E, Xi Y et al (2023) Stapled antimesenteric functional end-to-end anastomosis following intestinal resection for Crohn’s disease. Dis Colon Rectum 66(1):e4–e9. https://doi.org/10.1097/DCR.0000000000002481
doi: 10.1097/DCR.0000000000002481
pubmed: 36515520