ArticleTechniques in coloproctology2025
Comparing perioperative outcomes of stapled versus handsewn Kono-S anastomosis after ileocolonic resection for Crohn's disease.
Article in Techniques in coloproctology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Novel side-to-end anastomosis as an alternative in ileocecal Crohn's disease - an observational study.Updates in surgery · 2026Article
- Essential Updates in the Surgical Management of Inflammatory Bowel Disease: Current Topics From 2024 to Mid-2026.Annals of gastroenterological surgery · 2026Review
- Review
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7 authors.
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Abstract
introductionIleocecal resection is the most common surgery in Crohn's disease (CD). As recurrences often occur at the anastomosis it has been questioned whether surgical technique may have a role in its prevention. The Kono-S anastomosis, first described in 2011, has shown potential to reduce anastomotic recurrence while maintaining luminal width and preventing distortion. The classic surgery described was a handsewn anastomosis. Lately a stapled approach has emerged which is less technically demanding, and requires shorter operative time. We compared stapled versus handsewn Kono-S ileocolonic anastomosis in patients with Crohn's disease, evaluating operative time and perioperative outcomes.
methodsData on all consecutive patients with CD aged ≥ 18 years at a single tertiary center, who underwent ileocolonic resection by inflammatory bowel disease (IBD)-dedicated surgeons with Kono-S anastomosis from July 2023 to April 2025, were collected retrospectively.
resultsIn total, 25 patients were included. Overall, 15 (60%) underwent handsewn anastomosis and 10 (40%) underwent stapled anastomosis. There were no clinical or demographic differences. Median operative time was shorter in the stapled group (151 versus 203 min, p = 0.01). Postoperative complications occurred in 2/10 patients (20%) in the stapled group and 4/15 (26.7%) in the handsewn group (p = 0.70). One patient required reoperation in the handsewn group. Postoperative day 3 C-reactive protein (CRP) was lower in the stapled group (median 69 versus 165 mg/L, p = 0.03). There was one case of 30-day rehospitalization in the stapled group.
conclusionsThe stapled Kono-S anastomosis technique is a shorter procedure with similar perioperative outcomes compared with the handsewn technique. Follow-up studies, with larger sample sizes, are required to evaluate long-term efficacy and disease recurrence rates.
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