Surgical Prevention of Anastomotic Recurrence by Excluding Mesentery in Crohn's Disease: The SuPREMe-CD Study - A Randomized Clinical Trial.

Annals of Surgery
G LuglioL Bucci

Abstract

This trial aimed to provide randomized controlled data comparing Kono-S anastomosis and stapled ileocolic side-to-side anastomosis. Recently, a new antimesenteric, functional, end-to-end, hand-sewn ileocolic anastomosis (Kono-S) has shown a significant reduction in endoscopic recurrence score and surgical recurrence rate in Crohn disease (CD). Randomized controlled trial (RCT) at a tertiary referral institution. Primary endpoint: endoscopic recurrence (ER) (Rutgeerts score ≥i2) after 6 months. Secondary endpoints: clinical recurrence (CR) after 12 and 24 months, ER after 18 months, and surgical recurrence (SR) after 24 months. In all, 79 ileocolic CD patients were randomized in Kono group (36) and Conventional group (43). After 6 months, 22.2% in the Kono group and 62.8% in the Conventional group presented an ER [P < 0.001, odds ratio (OR) 5.91]. A severe postoperative ER (Rutgeerts score ≥i3) was found in 13.8% of Kono versus 34.8% of Conventional group patients (P = 0.03, OR 3.32). CR rate was 8% in the Kono group versus 18% in the Conventional group after 12 months (P = 0.2), and 18% versus 30.2% after 24 months (P = 0.04, OR 3.47). SR rate after 24 months was 0% in the Kono group versus 4.6% in the Conventional group (P = 0...Continue Reading

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Citations

Dec 17, 2020·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·Hideyuki SuzukiMichiaki Unno
Jun 22, 2020·Techniques in Coloproctology·G LuglioG D De Palma
Oct 8, 2020·Langenbeck's Archives of Surgery·K HorisbergerM Turina
Mar 2, 2021·Therapeutic Advances in Gastroenterology·Ravi S Shah, Benjamin H Click
Nov 21, 2020·Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen·Anton J Kroesen
Nov 9, 2020·Biology Direct·L PetagnaG S Sica
Feb 2, 2021·Annals of Medicine and Surgery·Rashid IbrahimAwad Alawad
Jan 19, 2021·Gastroenterology Research and Practice·S IngallinellaG S Sica
Feb 3, 2021·International Journal of Colorectal Disease·Elise Maria Meima-van PraagWilhelmus Adrianus Bemelman
May 18, 2020·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·A AlshanttiS R Brown
Jan 12, 2021·Journal of Immunology Research·B SensiA Divizia
Jul 18, 2020·Annals of Surgery·Toru Kono, Alessandro Fichera
Mar 17, 2020·Techniques in Coloproctology·G PellinoUNKNOWN Italian Society of Colorectal Surgery SICCR
Jun 12, 2020·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Adam LamJohn Alverdy
Jul 31, 2020·Expert Review of Gastroenterology & Hepatology·Takayuki YamamotoPaulo Gustavo Kotze

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