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Anastomotic configuration does not affect recurrence of Crohn's disease after ileocolonic resection

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Abstract

The influence of anastomotic configuration on recurrence of symptomatic Crohn's disease has been assessed in a sequential study of patients undergoing resection of ileal Crohn's disease. Between 1972 and 1991 92 patients had 102 ileocolonic anastomoses constructed after resection of intestinal Crohn's disease. The configuration of the ileocolonic anastomosis was either end to side (ES, n=68) or side to side (SS, n=34). The majority of patients in both groups were female and both groups were similar for duration of Crohn's disease at resection, steroid therapy, previous number of intestinal resections, indication for surgery and length of ileum resected at operation. No anastomotic leak occurred in either group. A total of 39 patients developed symptomatic recurrent Crohn's disease including 31 (46%) in the ES group and 8 (24%) in the SS group. This difference was related to the length of follow-up, the annual rate of symptomatic recurrence was almost identical for both end to side (0.066) and side to side (0.052) anastomoses.

Résumé

L'influence de la configuration d'une anastomose sur la récidive des symptômes de la maladie a été analysée dans une étude séquentielle de patients soumis à une résection iléale pour maladie de Crohn. De 1972 à 1991, 92 patients ont subi 102 anastomoses iléo-coliques après résection d'un segment intestinal pour maladie de Crohn. La configuration de l'anastomose iléo-clique a été termino-latérale (ES, n=68) ou latéro-latérale (SS, n=34). La majorité des patients dans les deux groupes était de sexe féminin et les deux groupes étaient similaires quant à la durée de l'évolution clinique de la maladie avant la résection, la corticothérapie, le nombre de résections intestinales réalisées par le passé, l'indication pour la chirurgie et la longueur du segment iléal réséqué. Aucune fuite anastomotique n'est survenue dans chacun des deux groupes. Trente-neuf patients ont développé une nouvelle poussée de la maladie de Crohn, soit 31 (46%) dans le groupe ES et 8 (24%) dans le groupe SS. Cette différence peut être mise en relation avec la durée du follow-up. Le taux annuel de récidives symptômatiques était identique dans les deux groupes ES (0,066) et SS (0,052).

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Scott, N.A., Sue-Ling, H.M. & Hughes, L.E. Anastomotic configuration does not affect recurrence of Crohn's disease after ileocolonic resection. Int J Colorect Dis 10, 67–69 (1995). https://doi.org/10.1007/BF00341197

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