用于克罗恩病吻合口复发手术预防的小野-S吻合术：一项国际多中心研究
Kono-S Anastomosis for Surgical Prophylaxis of Anastomotic Recurrence in Crohn's Disease: an International Multicenter Study.
作者信息
Kono Toru, Fichera Alessandro, Maeda Koutarou, Sakai Yoshiharu, Ohge Hiroki, Krane Mukta, Katsuno Hidetoshi, Fujiya Mikihiro
机构信息
Advanced Surgery Center, Sapporo Higashi Tokushukai Hospital, 3-1, N 33, E 14, Higashi-ku, Sapporo, Hokkaido, 065-0033, Japan.
Division of General Surgery, Department of Surgery, University of Washington Medical Center, Seattle, WA, USA.
出版信息
J Gastrointest Surg. 2016 Apr;20(4):783-90. doi: 10.1007/s11605-015-3061-3. Epub 2015 Dec 22.
INTRODUCTION
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.
METHODS
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.
RESULTS
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.
CONCLUSION
The Kono-S anastomosis appears to be safe and effective in reducing the risk of surgical recurrence in Crohn's disease.
引言
自2003年和2010年起，Kono-S（系膜对侧功能性端端手工缝合）吻合术分别在日本和美国用于克罗恩病的治疗。该技术旨在降低吻合口手术复发风险。本研究回顾了Kono-S吻合术应用于临床实践十年后的疗效。
方法
本研究在五家医院开展（四家在日本，一家在美国）。纳入了2003年9月至2011年9月期间因克罗恩病接受Kono-S吻合术的187例患者，其中日本患者144例（J组），美国患者43例（美国组）。
结果
中位随访65个月，J组发生了2例手术吻合口复发。Kaplan-Meier分析显示，J组5年和10年无手术复发生存率为98.6%。美国组中位随访32个月，未检测到手术吻合口复发。Kono-S吻合术在技术上可行，所有患者均成功实施。
结论
Kono-S吻合术在降低克罗恩病手术复发风险方面似乎安全有效。
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