Similar outcomes for Kono-S and side-to-side anastomosis in Crohn’s terminal ileitis

Kono-S and side-to-side anastomosis appeared to elicit comparable endoscopic recurrence rates, anastomotic strictures rates, and post-operative complication rates in patients undergoing ileocecectomy for Crohn’s terminal ileitis, preliminary data of a randomised trial revealed.

Dr Koianka Trencheva (Weill Cornell Medicine, NY, USA) and her research team aimed to compare Kono-S and side-to-side anastomosis following ileocecectomy for Crohn’s terminal ileitis [1]. In a multicentre trial (NCT03256240), 288 patients were randomised 1:1 to one of these interventions. The endoscopic recurrence rate at 3–6 months post-surgery was the main outcome measure.

The 3–6-month endoscopic recurrence rates were 25.9% and 27.8% in the Kono-S arm and side-to-side arm, respectively (P=0.78). “We noticed that the length of the surgical procedure was approximately 20 minutes longer in the Kono-S arm (mean 154 vs 132 minutes; P=0.39),” added Dr Trencheva. Furthermore, post-op complication rates and anastomotic stricture rates (3.0% vs 2.6%; P=1.00) were comparable for both arms.

“At 3–6 months follow-up, Kono-S and side-to-side anastomosis yield similar outcomes for patients undergoing ileocecectomy for Crohn’s terminal ileitis,” concluded Dr Trencheva.

1. Trencheva K, et al. Postoperative endoscopic recurrence after resection of Crohn’s terminal ileitis with Kono-S or side-to-side functional end anastomosis: results of a multicenter prospective randomized trial. OP20, 19^th Congress of ECCO, 21–24 February 2024, Stockholm, Sweden.

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Posted on 18 April 202418 April 2024