Dotlačil, Vojtěch; Lerchová, Tereza; Lengálová, Markéta; Kučerová, Barbora; Schwarz, Jan; Hradský, Ondřej; Rygl, Michal & Škába, Richard | Pediatrics Surgery International | March 2024 | IF: | doi
MUDr. Vojtěch Dotlačil, Department of Paediatrics Surgery, Second Faculty od Medicine and Motol University Hospital
Abstract
Purpose
Children diagnosed with Crohn's disease (CD) often undergo ileocecal resection (ICR) during childhood. Anastomotic recurrence is a frequent finding following this procedure. Data addressing the effect of the anastomosis type on disease recurrence are scarce in the pediatric population. The Kono-S anastomosis has shown promise in reducing endoscopic, clinical, and surgical recurrence rates in adults. We aimed to report our experience with Kono-S anastomosis in children, focusing on its feasibility and postoperative complications.
Methods
We retrospectively analyzed pediatric CD patients who underwent ICR with Kono-S anastomosis between August 2022 and May 2023. Data on demographics, clinical characteristics, surgery, hospitalization, and follow-up including colonoscopy were collected. Complications were classified using the Clavien-Dindo classification.
Results
Twelve patients (7 females, 58.3%) were included. Six (50%) of the patients had the B3 luminal form of the disease (according to Paris classification). Median surgery duration was 174 (interquartile range [IQR] 161–216) minutes. Anastomosis creation took a median of 62 (IQR, 54.5–71) minutes. Median hospitalization length was 6 (IQR 4–7) days. No short- or mid-term complications were observed. Median follow-up duration was 9.5 (IQR 6.8–12) months.
Conclusion
According to our results, Kono-S anastomosis is safe and feasible in pediatric CD patients, with no observed postoperative complications. These findings support the potential benefit of using Kono-S anastomosis as a treatment approach in children with CD.
