Effect of anastomotic configuration on Crohn ’s disease recurrence after primary ileocolic resection: a comparative monocentric study of end-to-end versus side-to-side anastomosis

AbstractThere is ongoing debate whether the type of anastomosis following intestinal resection for Crohn ’s disease (CD) can impact on complications and postoperative recurrence. The aim of the present study is to describe the outcomes of side-to-side (S–S) vs end-to-end (E–E) anastomosis after ileocecal resection for CD. A retrospective comparative study was conducted in consecutive CD patients who underwent primary ileocecal resection between 2005 and 2013. All patients underwent colonoscopy 6 months postoperatively to assess endoscopic recurrence, defined as Rutgeerts’ score (RS) ≥ i2. Surgical recurrence implied reoperation due to CD activity at the anastomotic site. Modified su rgical recurrence was defined as the need for reoperation or balloon-dilation. Perioperative factors related to recurrence were evaluated. Of the 127 patients included, 51 (40.2%) received an E–E anastomosis. Median follow-up was longer in the E–E group (8.62 vs 13.68 years). Apart from the mic roscopic resection margins, patient, disease and surgical characteristics were similar between both groups. Anastomotic complications were comparable (S–S 5.3% vs E–E 5.8%,p  = 1.00)0. Postoperatively, biologicals were used in 55.3% and 62.7% (p  = 0.47) in S –S and E–E patients, respectively. Endoscopic recurrence did not differ between S–S and E–E patients (78.9 vs 72.9%,p  = 0.37), with no significant difference in RS values between both groups (p  = 0.87). ...
Source: Updates in Surgery - Category: Surgery Source Type: research