Our Summary

This research paper discusses a new surgical technique for patients with Crohn’s disease, a chronic disease that causes inflammation in the digestive tract. When the disease affects a part of the bowel, that part is often removed, and the remaining ends are joined together in a process called anastomosis. However, there is a risk that the disease will recur at this join.

The researchers have been using a particular method called Kono-S anastomosis which has been shown to have a low risk of disease recurrence. However, this method can be time-consuming. Therefore, the researchers have developed a new version of this method that uses a surgical stapler. This new method is quicker to perform. The researchers tested this new method on 17 patients between January 2018 and June 2021.

The results showed that the average operation time was 106 minutes, and it took around 21 minutes to perform the stapling part of the operation. Patients were followed up for an average of 8.9 months, and 10 of them underwent a further endoscopy to check the status of the join. The average Rutgeerts score, a measure of disease recurrence, was 0.8, which indicates a low level of disease activity, and the rate of disease recurrence was 11.8%. There were no cases of postoperative deaths or leaks from the join.

The researchers conclude that this new stapling method could be a quick and safe way to perform the anastomosis procedure in patients with Crohn’s disease. However, they state that more studies are needed with a larger number of patients.

FAQs

  1. What is the Kono-S anastomosis technique used for in patients with Crohn’s disease?
  2. What are the preliminary results of the stapled antimesenteric functional end-to-end anastomosis procedure?
  3. What is the future direction for the stapled antimesenteric functional end-to-end anastomosis procedure in treating Crohn’s disease?

Doctor’s Tip

A doctor may advise a patient who has undergone intestinal resection to follow a strict diet to promote healing and reduce the risk of complications. This may include avoiding certain foods that can be difficult to digest, such as high-fiber or greasy foods, and focusing on a diet rich in lean proteins, fruits, and vegetables. It is also important for the patient to stay hydrated and follow any post-operative care instructions provided by their healthcare team. Regular follow-up appointments with the doctor are essential to monitor recovery and address any concerns that may arise.

Suitable For

Patients with Crohn’s disease who are at risk for anastomotic recurrence after bowel resection may be recommended for intestinal resection with stapled antimesenteric functional end-to-end anastomosis. This procedure has shown promising results in reducing the risk of anastomotic recurrence and may be a safe and time-saving option for these patients. Further research and prospective studies with a larger sample size are needed to confirm the efficacy and safety of this technique.

Timeline

Before intestinal resection:

  • Patient is diagnosed with Crohn’s disease and experiences symptoms such as abdominal pain, diarrhea, weight loss, and fatigue.
  • Patient undergoes imaging tests and endoscopy to confirm the diagnosis and assess the extent of bowel involvement.
  • Patient may be treated with medications such as corticosteroids, immunomodulators, and biologics to manage symptoms and control inflammation.
  • If medications are not effective or if there are complications such as strictures or fistulas, surgery may be recommended.

After intestinal resection:

  • Patient undergoes surgery to remove the affected portion of the bowel.
  • Stapled antimesenteric functional end-to-end anastomosis is performed to reconnect the remaining healthy bowel segments.
  • Patient may experience a recovery period in the hospital, where they are monitored for complications such as anastomotic leakage.
  • Follow-up appointments are scheduled to monitor the patient’s progress and assess for any signs of recurrence.
  • Patient may undergo surveillance endoscopy to evaluate the health of the anastomosis and look for any signs of inflammation or recurrence.
  • With proper care and management, the patient can experience improved symptoms and quality of life after intestinal resection.

What to Ask Your Doctor

  1. What is the success rate of stapled antimesenteric functional end-to-end anastomosis compared to traditional handsewn anastomosis in patients with Crohn’s disease?
  2. What are the potential risks and complications associated with this procedure?
  3. How long is the recovery period after undergoing stapled antimesenteric functional end-to-end anastomosis?
  4. Will I need to make any dietary or lifestyle changes after the procedure?
  5. How frequently will I need to undergo surveillance endoscopy to monitor for recurrence?
  6. Are there any alternative treatment options to consider for managing Crohn’s disease in the long term?

Reference

Authors: Duan M, Wu E, Xi Y, Wu Y, Gong J, Zhu W, Li Y. Journal: Dis Colon Rectum. 2023 Jan 1;66(1):e4-e9. doi: 10.1097/DCR.0000000000002481. Epub 2022 Aug 26. PMID: 36515520