Department of Paediatric Surgery, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Charles University, V Uvalu 84, 150 06, Praha 5, Czech Republic.
Department of Paediatrics, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic.
Pediatr Surg Int. 2024 Mar 5;40(1):67. doi: 10.1007/s00383-024-05648-6.
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.
儿童克罗恩病（CD）患者常需接受回盲部切除术（ICR）。吻合口复发是该手术后的常见并发症。在儿科人群中，有关吻合方式对疾病复发影响的数据较为匮乏。Kono-S 吻合术在降低成人内镜、临床和手术复发率方面显示出良好的效果。我们旨在报告我们在儿童中应用 Kono-S 吻合术的经验，重点关注其可行性和术后并发症。
我们回顾性分析了 2022 年 8 月至 2023 年 5 月期间接受 Kono-S 吻合术的儿童 CD 患者。收集了人口统计学、临床特征、手术、住院和随访（包括结肠镜检查）数据。并发症采用 Clavien-Dindo 分类进行分类。
共纳入 12 例患者（7 例女性，58.3%）。其中 6 例（50%）患者的疾病存在 B3 腔外型（根据巴黎分类）。手术时间中位数为 174 分钟（四分位距 [IQR] 161-216）。吻合口建立时间中位数为 62 分钟（IQR 54.5-71）。中位住院时间为 6 天（IQR 4-7）。无近期或中期并发症。中位随访时间为 9.5 个月（IQR 6.8-12）。
根据我们的结果，Kono-S 吻合术在儿童 CD 患者中是安全且可行的，术后无并发症发生。这些发现支持 Kono-S 吻合术作为儿童 CD 治疗方法的潜在益处。
