Antimesenteric functional end-to-end handsewn (Kono-S) anastomosis.

Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract
Alessandro FicheraToru Kono

Abstract

Anastomotic recurrence is a frequent event after bowel resection for Crohn's disease. To date, no anastomotic technique has been proven to be superior in reducing surgical recurrence rates in this setting. In this article, we describe our technique in performing a new antimesenteric functional end-to-end handsewn (Kono-S) anastomosis. The segment of bowel to be resected is identified and mobilized. The bowel is then divided transversely with a linear stapler-cutter device. The intervening mesentery is divided close to the bowel. The corners of the two stapled lines are sutured together, and the two stapled lines are approximated with interrupted sutures. An antimesenteric longitudinal enterotomy is performed on both sides, starting no more than 1 cm away from the staple line, to allow a transverse lumen of 7-8 cm. The openings are closed transversely in two layers. From May 1, 2010 to July 31, 2011 we performed 46 Kono-S anastomoses. One patient had a contained anastomotic leak successfully treated conservatively. Currently, 18 patients (43 %) have undergone follow-up endoscopic surveillance with an average Rutgeert's score of 0.7 (0-3) at a mean of 6.8 months. The Kono-S anastomosis is a safe anastomotic technique. Long-term s...Continue Reading

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Citations

Nov 28, 2012·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Takayuki Yamamoto
Oct 26, 2018·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Norimitsu ShimadaTaijiro Sueda
Apr 20, 2014·Annals of Surgery·Fabrizio Michelassi, Samuel Sultan
Dec 24, 2015·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Toru KonoMikihiro Fujiya
May 18, 2020·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·A AlshanttiS R Brown
Jan 4, 2020·Updates in Surgery·Roberto PeltriniLuigi Bucci
Apr 21, 2016·Journal of Clinical Laboratory Analysis·Silvia SaleVincenzo Rocco
Jul 22, 2014·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·T Kono, A Fichera
Jul 14, 2018·Annals of Gastroenterological Surgery·Tadahiko MasakiHiroyoshi Matsuoka
Jul 18, 2020·Annals of Surgery·Toru Kono, Alessandro Fichera
Oct 24, 2014·World Journal of Gastroenterology : WJG·Tara M Connelly, Evangelos Messaris
Mar 29, 2014·Digestive Diseases and Sciences·Fabrizio Michelassi
Oct 8, 2020·Langenbeck's Archives of Surgery·K HorisbergerM Turina
Oct 10, 2020·Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen·S FlemmingC-T Germer
Nov 9, 2020·Biology Direct·L PetagnaG S Sica
Jan 12, 2021·Journal of Immunology Research·B SensiA Divizia
Nov 10, 2020·Clinics in Colon and Rectal Surgery·Toru Kono, Alessandro Fichera

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