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Isoperistaltic side-to-side anastomosis for the surgical treatment of Crohn disease

PURPOSE: Increasing evidence has shown an association of surgical technique, particularly anastomotic configuration, with postoperative recurrence of CD. This pilot study aimed to evaluate short-term outcomes of isoperistaltic side-to-side anastomosis (ISSA) employed on Crohn disease (CD) patients....

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Autores principales: Chen, Wenhao, Zhou, Junjie, Chen, Min, Jiang, Congqing, Qian, Qun, Ding, Zhao
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Surgical Society 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9300438/
https://www.ncbi.nlm.nih.gov/pubmed/35919111
http://dx.doi.org/10.4174/astr.2022.103.1.53
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author Chen, Wenhao
Zhou, Junjie
Chen, Min
Jiang, Congqing
Qian, Qun
Ding, Zhao
author_facet Chen, Wenhao
Zhou, Junjie
Chen, Min
Jiang, Congqing
Qian, Qun
Ding, Zhao
author_sort Chen, Wenhao
collection PubMed
description PURPOSE: Increasing evidence has shown an association of surgical technique, particularly anastomotic configuration, with postoperative recurrence of CD. This pilot study aimed to evaluate short-term outcomes of isoperistaltic side-to-side anastomosis (ISSA) employed on Crohn disease (CD) patients. METHODS: Data were retrieved from a prospectively maintained database. Postoperatively, all patients were followed up with close endoscopic (ileocolonoscopy) surveillance. RESULTS: From January 2017 to May 2021, 30 patients diagnosed with CD who underwent ISSA were compared with 45 CD patients who underwent antiperistaltic side-to-side anastomosis (ASSA). The 2 groups were comparable in baseline demographics and clinical characteristics. No significant differences were observed between groups regarding postoperative safety issues, including anastomotic leak, abdominal/pelvic abscess, length of hospital stay, readmission rate within 30 days, etc. At postoperative 24th month, reduced endoscopic recurrence was observed in the ISSA group compared with that in the ASSA group (18 of 24, 75.0%, vs. 36 of 38, 94.7%; P = 0.024). Regarding surgical recurrence, there was 0% in the ISSA group vs. 4.4% (2 of 45) in the ASSA group (P = 0.510). CONCLUSION: In this study, we aimed to explore the influence of ISSA on postoperative recurrence in CD patients, and the preliminary results show that ISSA was technically safe and feasible, and appears to be effective in reducing postoperative recurrence in CD patients. However, our conclusion was underpowered due to small sample size and inadequate follow-up. We proposed ISSA be considered as another alternative option in the toolbox of inflammatory bowel disease surgeons when performing anastomosis on CD patients.
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spelling pubmed-93004382022-08-01 Isoperistaltic side-to-side anastomosis for the surgical treatment of Crohn disease Chen, Wenhao Zhou, Junjie Chen, Min Jiang, Congqing Qian, Qun Ding, Zhao Ann Surg Treat Res Original Article PURPOSE: Increasing evidence has shown an association of surgical technique, particularly anastomotic configuration, with postoperative recurrence of CD. This pilot study aimed to evaluate short-term outcomes of isoperistaltic side-to-side anastomosis (ISSA) employed on Crohn disease (CD) patients. METHODS: Data were retrieved from a prospectively maintained database. Postoperatively, all patients were followed up with close endoscopic (ileocolonoscopy) surveillance. RESULTS: From January 2017 to May 2021, 30 patients diagnosed with CD who underwent ISSA were compared with 45 CD patients who underwent antiperistaltic side-to-side anastomosis (ASSA). The 2 groups were comparable in baseline demographics and clinical characteristics. No significant differences were observed between groups regarding postoperative safety issues, including anastomotic leak, abdominal/pelvic abscess, length of hospital stay, readmission rate within 30 days, etc. At postoperative 24th month, reduced endoscopic recurrence was observed in the ISSA group compared with that in the ASSA group (18 of 24, 75.0%, vs. 36 of 38, 94.7%; P = 0.024). Regarding surgical recurrence, there was 0% in the ISSA group vs. 4.4% (2 of 45) in the ASSA group (P = 0.510). CONCLUSION: In this study, we aimed to explore the influence of ISSA on postoperative recurrence in CD patients, and the preliminary results show that ISSA was technically safe and feasible, and appears to be effective in reducing postoperative recurrence in CD patients. However, our conclusion was underpowered due to small sample size and inadequate follow-up. We proposed ISSA be considered as another alternative option in the toolbox of inflammatory bowel disease surgeons when performing anastomosis on CD patients. The Korean Surgical Society 2022-07 2022-07-07 /pmc/articles/PMC9300438/ /pubmed/35919111 http://dx.doi.org/10.4174/astr.2022.103.1.53 Text en Copyright © 2022, the Korean Surgical Society https://creativecommons.org/licenses/by-nc/4.0/Annals of Surgical Treatment and Research is an Open Access Journal. All articles are distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) ) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Chen, Wenhao
Zhou, Junjie
Chen, Min
Jiang, Congqing
Qian, Qun
Ding, Zhao
Isoperistaltic side-to-side anastomosis for the surgical treatment of Crohn disease
title Isoperistaltic side-to-side anastomosis for the surgical treatment of Crohn disease
title_full Isoperistaltic side-to-side anastomosis for the surgical treatment of Crohn disease
title_fullStr Isoperistaltic side-to-side anastomosis for the surgical treatment of Crohn disease
title_full_unstemmed Isoperistaltic side-to-side anastomosis for the surgical treatment of Crohn disease
title_short Isoperistaltic side-to-side anastomosis for the surgical treatment of Crohn disease
title_sort isoperistaltic side-to-side anastomosis for the surgical treatment of crohn disease
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9300438/
https://www.ncbi.nlm.nih.gov/pubmed/35919111
http://dx.doi.org/10.4174/astr.2022.103.1.53
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