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The Sasaki-W anastomosis for recurrent Crohn’s disease stenosis after the Kono-S anastomosis
BACKGROUND: Postoperative recurrence is frequently encountered in the management of patients with Crohn’s disease and is most often found at the anastomotic site. A novel technique, the Sasaki-W anastomosis, is an antimesenteric cutback end-to-end isoperistaltic anastomosis. We report a patient with...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Springer Berlin Heidelberg
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10541374/ https://www.ncbi.nlm.nih.gov/pubmed/37773306 http://dx.doi.org/10.1186/s40792-023-01747-z |
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author | Asai, Takahiro Shinozaki, Hiroharu Shinozaki, Satoshi Makino, Akitsugu Nakagawa, Masashi Kobayashi, Kenji Lefor, Alan Kawarai Yukisawa, Seigo Ogata, Yoshiro |
author_facet | Asai, Takahiro Shinozaki, Hiroharu Shinozaki, Satoshi Makino, Akitsugu Nakagawa, Masashi Kobayashi, Kenji Lefor, Alan Kawarai Yukisawa, Seigo Ogata, Yoshiro |
author_sort | Asai, Takahiro |
collection | PubMed |
description | BACKGROUND: Postoperative recurrence is frequently encountered in the management of patients with Crohn’s disease and is most often found at the anastomotic site. A novel technique, the Sasaki-W anastomosis, is an antimesenteric cutback end-to-end isoperistaltic anastomosis. We report a patient with Crohn’s disease who underwent partial intestinal resection for postoperative anastomotic stenosis, reconstructed with the Sasaki-W anastomosis, after initial intestinal resection reconstructed with a Kono-S anastomosis. CASE PRESENTATION: A 30-year-old male was diagnosed with Crohn’s disease and treated with mesalamine and adalimumab, and he underwent ileocecal resection using the Kono-S anastomosis at the time of diagnosis. He was treated with infliximab without any symptoms or recurrence for 7 years. He was admitted presenting with upper abdominal pain. Physical examination showed mild tenderness and distension in the upper abdomen. Laboratory data showed no remarkable findings. Computed tomography scan showed wall thickening in the ileum with proximal dilation and fluid retention. Non-operative management with antibiotics and fasting did not improve the symptoms within 7 days. Ten days after admission, ileocecal resection reconstructed with the Sasaki-W anastomosis was performed. At operation, there was a 15-cm intestinal stenosis at the site of the previous Kono-S anastomosis. The transverse colon and ileum were reconstructed with the Sasaki-W anastomosis. The postoperative course was uneventful, and the patient was discharged 17 days postoperatively. The patient had no obstructive symptoms and no findings consistent with bowel obstruction were observed on computed tomography scan one year postoperatively. CONCLUSIONS: The Sasaki-W anastomosis is a viable option for intestinal reconstruction in patients with postoperative recurrence after a Kono-S anastomosis. |
format | Online Article Text |
id | pubmed-10541374 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
spelling | pubmed-105413742023-10-01 The Sasaki-W anastomosis for recurrent Crohn’s disease stenosis after the Kono-S anastomosis Asai, Takahiro Shinozaki, Hiroharu Shinozaki, Satoshi Makino, Akitsugu Nakagawa, Masashi Kobayashi, Kenji Lefor, Alan Kawarai Yukisawa, Seigo Ogata, Yoshiro Surg Case Rep Case Report BACKGROUND: Postoperative recurrence is frequently encountered in the management of patients with Crohn’s disease and is most often found at the anastomotic site. A novel technique, the Sasaki-W anastomosis, is an antimesenteric cutback end-to-end isoperistaltic anastomosis. We report a patient with Crohn’s disease who underwent partial intestinal resection for postoperative anastomotic stenosis, reconstructed with the Sasaki-W anastomosis, after initial intestinal resection reconstructed with a Kono-S anastomosis. CASE PRESENTATION: A 30-year-old male was diagnosed with Crohn’s disease and treated with mesalamine and adalimumab, and he underwent ileocecal resection using the Kono-S anastomosis at the time of diagnosis. He was treated with infliximab without any symptoms or recurrence for 7 years. He was admitted presenting with upper abdominal pain. Physical examination showed mild tenderness and distension in the upper abdomen. Laboratory data showed no remarkable findings. Computed tomography scan showed wall thickening in the ileum with proximal dilation and fluid retention. Non-operative management with antibiotics and fasting did not improve the symptoms within 7 days. Ten days after admission, ileocecal resection reconstructed with the Sasaki-W anastomosis was performed. At operation, there was a 15-cm intestinal stenosis at the site of the previous Kono-S anastomosis. The transverse colon and ileum were reconstructed with the Sasaki-W anastomosis. The postoperative course was uneventful, and the patient was discharged 17 days postoperatively. The patient had no obstructive symptoms and no findings consistent with bowel obstruction were observed on computed tomography scan one year postoperatively. CONCLUSIONS: The Sasaki-W anastomosis is a viable option for intestinal reconstruction in patients with postoperative recurrence after a Kono-S anastomosis. Springer Berlin Heidelberg 2023-09-29 /pmc/articles/PMC10541374/ /pubmed/37773306 http://dx.doi.org/10.1186/s40792-023-01747-z Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Case Report Asai, Takahiro Shinozaki, Hiroharu Shinozaki, Satoshi Makino, Akitsugu Nakagawa, Masashi Kobayashi, Kenji Lefor, Alan Kawarai Yukisawa, Seigo Ogata, Yoshiro The Sasaki-W anastomosis for recurrent Crohn’s disease stenosis after the Kono-S anastomosis |
title | The Sasaki-W anastomosis for recurrent Crohn’s disease stenosis after the Kono-S anastomosis |
title_full | The Sasaki-W anastomosis for recurrent Crohn’s disease stenosis after the Kono-S anastomosis |
title_fullStr | The Sasaki-W anastomosis for recurrent Crohn’s disease stenosis after the Kono-S anastomosis |
title_full_unstemmed | The Sasaki-W anastomosis for recurrent Crohn’s disease stenosis after the Kono-S anastomosis |
title_short | The Sasaki-W anastomosis for recurrent Crohn’s disease stenosis after the Kono-S anastomosis |
title_sort | sasaki-w anastomosis for recurrent crohn’s disease stenosis after the kono-s anastomosis |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10541374/ https://www.ncbi.nlm.nih.gov/pubmed/37773306 http://dx.doi.org/10.1186/s40792-023-01747-z |
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