Skip to main content
SpringerLink
Log in

Totally stapled Kono-S anastomosis for Crohn’s disease

  • Technical Note
  • Published:
Techniques in Coloproctology Aims and scope Submit manuscript

Abstract

Postoperative recurrence (POR) rates after resection for Crohn’s disease (CD) are high. Whether the type of anastomosis affects POR is still debated. Recently, an anti-mesenteric hand-sewn end-to-end anastomosis (Kono-S) has been proposed as an additional measure to reduce recurrence. A randomized controlled trial demonstrated a significant reduction of endoscopic and clinical POR when the Kono-S anastomosis was compared to stapled ileocolic side-to-side anastomosis. However the hand- sewn technique might potentially limit use of this new type of anastomosis. The aim of this paper was to illustrate the technique of a totally stapled Kono-S anastomosis, and to discuss its potential advantages in surgery for CD.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

References

  1. 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

    Article  Google Scholar 

  2. Kalman TD, Everhov AH, Nordenvall C, Sachs MC, Halfvarson J, Ekbom A et al (2020) Decrease in primary but not in secondary abdominal surgery for Crohn’s disease: nationwide cohort study, 1990–2014. Br J Surg 107(11):1529–1538

    Article  CAS  Google Scholar 

  3. Wolford DD, Fichera A (2020) Prophylaxis of Crohn’s disease recurrence: a surgeon’s perspective. Ann Gastroenterol Surg 4(5):514–520

    Article  Google Scholar 

  4. Rutgeerts P, Goboes K, Peeters M, Hiele M, Penninckx F, Aerts R et al (1991) Effect of faecal stream diversion on recurrence of Crohn’s disease in the neoterminal ileum. Lancet 338(8770):771–774

    Article  CAS  Google Scholar 

  5. McLeod RS, Wolff BG, Ross S, Parkes R, McKenzie M, Investigators of the CT (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

    Article  Google Scholar 

  6. Rutgeerts P, Geboes K, Vantrappen G, Kerremans R, Coenegrachts JL, Coremans G (1984) Natural history of recurrent Crohn’s disease at the ileocolonic anastomosis after curative surgery. Gut 25(6):665–672

    Article  CAS  Google Scholar 

  7. Fichera A, Zoccali M, Kono T (2012) Antimesenteric functional end-to-end handsewn (Kono-S) anastomosis. J Gastrointest Surg 16(7):1412–1416

    Article  Google Scholar 

  8. Yamamoto T (2013) A new anastomotic technique for prevention of postoperative recurrence in Crohn’s disease. J Gastrointest Surg 17(6):1169

    Article  Google Scholar 

  9. Luglio G, Rispo A, Imperatore N, Giglio MC, Amendola A, Tropeano FP 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

    Article  Google Scholar 

  10. Ng CH, Chin YH, Lin SY, Koh JWH, Lieske B, Koh FH et al (2021) Kono-S anastomosis for crohn’s disease: a systemic review, meta-analysis, and meta-regression. Surg Today 51(4):493–501

    Article  Google Scholar 

  11. Simillis C, Purkayastha S, Yamamoto T, Strong SA, Darzi AW, Tekkis PP (2007) A meta-analysis comparing conventional end-to-end anastomosis vs other anastomotic configurations after resection in Crohn’s disease. Dis Colon Rectum 50(10):1674–1687

    Article  Google Scholar 

  12. Ravitch MM, Steichen FM (1972) Technics of staple suturing in the gastrointestinal tract. Ann Surg 175(6):815–837

    Article  CAS  Google Scholar 

  13. (2017)Prospective Randomized Study of the Kono‐S Anastomosis Versus the Side‐to‐side Functional End Anastomosis in the Prevention of Post‐operative Recurrence of Crohn's Disease. Cochrane Central Register of Controlled Trials (CENTRAL).

Download references

Funding

No sources of funding for research and/or publications.

Informed consent

All involved persons gave their informed consent prior to study inclusion.

Ethical approval

Ethical approval from the local hospital board was obtained before study initiation.

Conflict of Interest

Authors have no conflict of interest to declare.

Author information

Authors and Affiliations

  1. Department of Abdominal Surgery, University Hospitals Leuven, KU Leuven, 3000, Leuven, Belgium

    G. Bislenghi, S. Devriendt, A. Wolthuis & A. D’Hoore

Authors
  1. G. Bislenghi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. S. Devriendt
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. A. Wolthuis
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. A. D’Hoore
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to G. Bislenghi.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Article not based on previous communication to societies/meetings.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Bislenghi, G., Devriendt, S., Wolthuis, A. et al. Totally stapled Kono-S anastomosis for Crohn’s disease. Tech Coloproctol 26, 213–216 (2022). https://doi.org/10.1007/s10151-021-02551-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10151-021-02551-3

Keywords

Search

Navigation