Safety and feasibility of the KONO-S anastomosis technique with biodegradable stent in Crohn's disease: a pilot study.

BACKGROUND AND AIMS

The KONO-S (antimesenteric functional end-to-end handsewn) anastomosis has been used for Crohn's disease (CD) recently, with its efficacy in reducing the risk of anastomotic surgical recurrence. However, the anastomotic leakage is also found in CD with this technique. This study aims to evaluate the safety and feasibility of the KONO-S anastomosis with biodegradable stent in CD.

METHODS

We performed a study of 56 CD patients undergoing bowel resection by the KONO-S anastomosis technique with or without biodegradable stent. Postoperative complications, time to first flatus, time to first defecation, and healing of the anastomosis were recorded, especially in patients receiving biodegradable stent.

RESULT

The study included 24 CD patients receiving KONO-S anastomosis with biodegradable stent and 32 patients receiving normal KONO-S anastomosis. In patients with biodegradable stent, 8 patients received small bowel resection, 15 received ileocecal resection, and 1 received colectomy; the mean time for the new anastomosis technique was 15.8 ± 2.0 min. No stent-related complications were observed postoperatively. The time to first flatus and defecation was 2.3 ± 0.5 days and 3.7 ± 0.8 days in patients with biodegradable stent, respectively. All the stents degraded at almost 4-5 weeks after surgery. The colonoscopy showed that the healing condition of the anastomosis was good without any recurrence during 6-month follow-up in the stent group.

CONCLUSION

This is a pilot study that showed that the KONO-S anastomosis technique with biodegradable stent was safe and feasible in CD with lower risk of anastomotic complications and no serious adverse events.