Does stapled functional end-to-end anastomosis affect recurrence of Crohn's disease after ileocolonic resection?
OBJECTIVE
Crohn's disease is characterized by a high incidence of perianastomotic recurrence after ileocolonic resection. The influence of anastomotic configuration on the incidence of reoperation was evaluated in patients undergoing resection for Crohn's disease.


METHODS
106 patients affected by ileocolonic Crohn's disease were divided in two groups: group I with a hand-sewn end-to-side or side-to-side isoperistaltic anastomosis (30 patients) and group II with functional end-to-end anastomosis made with linear staplers (76 patients).


RESULTS
The morbidity was 4.7%: 3 complications and a postoperative death occurred in group I and two complications occurred in group II. There were 5 recurrences (16.7%) in the hand-sewn group and 2 recurrences (2.6%) in the stapled group, with a recurrence rate of 3.54 and 0.92, respectively.


CONCLUSIONS
Our non-randomized study suggests a better trend toward the functional stapled technique, in terms of recurrence rate. These observations need further investigation with randomized controlled trials, to compare the two different anastomotic procedures.
Department of Surgical Sciences, General Surgery 1, San Camillo Hospital, Rome, Italy.
Roberto
R
Tersigni
Luciano
L
Alessandroni
Marco
M
Barreca
Paolo
P
Piovanello
Cosimo
C
Prantera
D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical / Q000379:methods; D003106:Colon / Q000601:surgery; D003424:Crohn Disease / Q000517:prevention & control / Q000601:surgery*; D005260:Female; D006801:Humans; D007082:Ileum / Q000601:surgery; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D055502:Secondary Prevention; D017792:Surgical Stapling / Q000379:methods*; D016896:Treatment Outcome