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Kono-S Anastomosis for Surgical Prophylaxis of Anastomotic Recurrence in Crohn’s Disease: an International Multicenter Study

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Journal of Gastrointestinal Surgery Aims and scope

Abstract

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.

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Author information

Authors and Affiliations

  1. Advanced Surgery Center, Sapporo Higashi Tokushukai Hospital, 3-1, N 33, E 14, Higashi-ku, Sapporo, Hokkaido, 065-0033, Japan

    Toru Kono

  2. Division of General Surgery, Department of Surgery, University of Washington Medical Center, Seattle, WA, USA

    Alessandro Fichera & Mukta Krane

  3. Department of Surgery, Fujita Health University, School of Medicine, Toyoake, Aichi, Japan

    Koutarou Maeda & Hidetoshi Katsuno

  4. Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan

    Yoshiharu Sakai

  5. Department of Infectious Diseases, Hiroshima University Hospital, Hiroshima, Japan

    Hiroki Ohge

  6. Division of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, Asahikawa, Japan

    Mikihiro Fujiya

Authors
  1. Toru Kono
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  2. Alessandro Fichera
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  3. Koutarou Maeda
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  4. Yoshiharu Sakai
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  5. Hiroki Ohge
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  6. Mukta Krane
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  7. Hidetoshi Katsuno
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  8. Mikihiro Fujiya
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Corresponding author

Correspondence to Toru Kono.

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This retrospective study protocol was approved by the local ethics board of each participating institution.

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Kono, T., Fichera, A., Maeda, K. et al. Kono-S Anastomosis for Surgical Prophylaxis of Anastomotic Recurrence in Crohn’s Disease: an International Multicenter Study. J Gastrointest Surg 20, 783–790 (2016). https://doi.org/10.1007/s11605-015-3061-3

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  • DOI: https://doi.org/10.1007/s11605-015-3061-3

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