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Kono-S anastomosis in Crohn’s disease: initial experience in pediatric patients

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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.

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Data availability

All data supporting the findings of this study are available.

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Acknowledgements

We would like to express our gratitude to Ludmila Kozakova, M.D. for providing the illustrations of the Kono-S anastomosis.

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Authors and Affiliations

  1. Department of Paediatric Surgery, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Charles University, V Uvalu 84, 150 06, Praha 5, Czech Republic

    Vojtech Dotlacil, Barbora Kucerova, Michal Rygl & Richard Skaba

  2. Department of Paediatrics, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic

    Tereza Lerchova & Ondrej Hradsky

  3. Department of Surgery, NH Hospital a.s., Horovice, Czech Republic

    Marketa Lengalova

  4. Department of Paediatrics, Faculty of Medicine in Pilsen, Faculty Hospital, Charles University in Prague, Pilsen, Czech Republic

    Jan Schwarz

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  1. Vojtech Dotlacil
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Contributions

V.D. wrote the main manuscript. V.D., O.H., T. L. prepared the statistics. All authors reviewed the manuscript.

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Correspondence to Vojtech Dotlacil.

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Dotlacil, V., Lerchova, T., Lengalova, M. et al. Kono-S anastomosis in Crohn’s disease: initial experience in pediatric patients. Pediatr Surg Int 40, 67 (2024). https://doi.org/10.1007/s00383-024-05648-6

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