BACKGROUND/AIMS: Anastomotic recurrence after bowel resection is a major problem in Crohn's disease surgery. The aim of this study is to compare recurrence rate after stapled side-to-side ileo-colonic anastomosis to those after stapled end-to-side or hand-sewn side-to-side anastomosis to distinguish the role of suture technique and anastomotic configuration in the prevention of Crohn's disease recurrence. METHODOLOGY: Eighty-four consecutive patients who had undergone ileo-colonic resection for Crohn's disease were enrolled: 12 of them had stapled side-to-side anastomosis, 36 stapled end-to-side anastomosis and 36 hand-sewn side-to-side anastomosis. We evaluated duration of operation, first bowel movement after operation, postoperative hospital staying, postoperative surgical complications, clinical recurrence and reoperation rate. The statistical analysis was performed using Student's t-test and Fisher exact test. Cumulative recurrence rates were compared using F Cox test and Kaplan-Meier method. RESULTS: No statistically significant difference between the three groups was observed in early postoperative follow up. The stapled side-to-side anastomosis group obtained a better symptom-free survival than the stapled end-to-side group (p=0.04). In the stapled and hand-sewn side-to-side groups reoperation rates were significantly lower than in the stapled end-to-side group (p=0.01 and p=0.05 respectively). CONCLUSIONS: All the three types of anastomosis were demonstrated to be equally safe in early postoperative outcome. A longer follow-up showed a significantly lower incidence of reoperation recurrence in the stapled and hand-sewn side-to-side anastomosis compared to the stapled end-to-side anastomosis group. This result may suggest the configuration of the anastomosis as the key point in the recurrence of anastomotic Crohn's disease.
BACKGROUND/AIMS: Anastomotic recurrence after bowel resection is a major problem in Crohn's disease surgery. The aim of this study is to compare recurrence rate after stapled side-to-side ileo-colonic anastomosis to those after stapled end-to-side or hand-sewn side-to-side anastomosis to distinguish the role of suture technique and anastomotic configuration in the prevention of Crohn's disease recurrence. METHODOLOGY: Eighty-four consecutive patients who had undergone ileo-colonic resection for Crohn's disease were enrolled: 12 of them had stapled side-to-side anastomosis, 36 stapled end-to-side anastomosis and 36 hand-sewn side-to-side anastomosis. We evaluated duration of operation, first bowel movement after operation, postoperative hospital staying, postoperative surgical complications, clinical recurrence and reoperation rate. The statistical analysis was performed using Student's t-test and Fisher exact test. Cumulative recurrence rates were compared using F Cox test and Kaplan-Meier method. RESULTS: No statistically significant difference between the three groups was observed in early postoperative follow up. The stapled side-to-side anastomosis group obtained a better symptom-free survival than the stapled end-to-side group (p=0.04). In the stapled and hand-sewn side-to-side groups reoperation rates were significantly lower than in the stapled end-to-side group (p=0.01 and p=0.05 respectively). CONCLUSIONS: All the three types of anastomosis were demonstrated to be equally safe in early postoperative outcome. A longer follow-up showed a significantly lower incidence of reoperation recurrence in the stapled and hand-sewn side-to-side anastomosis compared to the stapled end-to-side anastomosis group. This result may suggest the configuration of the anastomosis as the key point in the recurrence of anastomotic Crohn's disease.
Authors: S P L Travis; E F Stange; M Lémann; T Oresland; Y Chowers; A Forbes; G D'Haens; G Kitis; A Cortot; C Prantera; P Marteau; J-F Colombel; P Gionchetti; Y Bouhnik; E Tiret; J Kroesen; M Starlinger; N J Mortensen Journal: Gut Date: 2006-03 Impact factor: 23.059
Authors: G Pellino; D S Keller; G M Sampietro; I Angriman; M Carvello; V Celentano; F Colombo; F Di Candido; S Laureti; G Luglio; G Poggioli; M Rottoli; S Scaringi; G Sciaudone; G Sica; L Sofo; S Leone; S Danese; A Spinelli; G Delaini; F Selvaggi Journal: Tech Coloproctol Date: 2020-03-14 Impact factor: 3.781