P0650 Comparative study between Kono-S and latero-lateral isoperistaltic anastomosis in the treatment of terminal ileum Crohn’s Disease patients: perioperative complications and short-term results
Notice bibliographique
Résumé
Abstract Background The main challenge in surgical treatment for terminal ileal Crohn’s Disease is represented by the significant recurrence at the anastomotic site after ileocecal resection.1 Latero-lateral anastomosis is frequently performed in this kind of surgery because of its characteristics of ductility and reproducibility; the Kono-S anastomosis - characterized by a supporting structure and a wider lumen - was recently introduced to reduce the risk of recurrence.2 Several studies indicate a reduction in recurrence and complications, but evidence remains limited and controversial, particularly for long-term follow-up.3, 4 Methods This monocentric study included 30 Crohn’s patients admitted in a Tertiary Care IBD Centre in Milan between 2023 and 2024, comparing 10 patients who underwent Kono-S anastomosis with 20 who underwent latero-lateral isoperistaltic anastomosis. Both groups included patients with ileal stenosing Crohn’s Disease (B2-L1 according to the Montreal classification). Surgery was performed with a mini-invasive approach, and the selected patients were naïve to abdominal surgery for Crohn’s. Results Preoperative variables considered included the mean age of the patients, BMI, sex, smoking habit, Charlson Comorbidity Index (CCI), ASA score, duration of illness at the time of surgery. Regarding postoperative data, blood glucose showed significantly higher mean values in the Kono-S group (125.1 ± 26.3 mg/dL) than in the latero-lateral group (105.7 ± 20.1 mg/dL). About postoperative complications, our data shows that one patient in the Kono-S group developed perianastomotic abscess, one other needed blood transfusion for anaemia and one patient underwent reintervention for anastomotic bleeding (Clavien-Dindo 3b). In the latero-lateral group, two patients developed anaemia (without needing blood transfusion) and other two needed blood transfusion; finally, one patient developed anastomotic leak requiring reintervention. The mortality was nil. Other postoperative data (such as duration of surgery, C-Reactive Protein in 1 and 3 postoperative days, number of days before gas flatus and stool canalization, fever, assumption of diet, number of days before discharge, re-admission and re-intervention) were analysed (reported in the attached table). Conclusion Our results indicate an overlap between the two techniques in terms of safety and perioperative management, with a comparable rate of major complications such as anastomotic dehiscence (0% in the Kono-S group versus 5% in the latero-lateral group) or readmission. However, the small sample size limits the scope of the results and suggests the need for further studies to assess the actual impact of the Kono-S technique on long-term recurrence. References 1.Nos P, Domenech E. Postoperative Crohn’s disease recurrence: a practical approach. World J Gastroenterol 2008;14(36):5540–5548. 2.Kono T, Fichera A, Maeda K, et al. Kono-S anastomosis for surgical prophylaxis of anastomotic recurrence in Crohn’s disease: an International Multicenter Study. J Gastrointest Surg 2016;20 (04):783–790. 3.Alshantti A, Hind D, Hancock L, Brown SR. The role of Kono-S anastomosis and mesenteric resection in reducing recurrence after surgery for Crohn’s disease: a systematic review. Colorectal Dis. 2021 Jan;23(1):7-17. 4.Baloyiannis I, Perivoliotis K, Sarakatsianou C, Chatzinikolaou C, Tzovaras G. The Reduction of Anastomosis-Related Morbidity Using the Kono-S Anastomosis in Patients with Crohn’s Disease: A Meta-Analysis. J Clin Med. 2024 Apr 23;13(9):2461.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».