title: Kono-S Anastomosis for Surgical Prophylaxis of Anastomotic Recurrence in Crohn's Disease: an International Multicenter Study.
abstract: BACKGROUND
  The Kono-S (antimesenteric functional end-to-end handsewn) anastomosis has been used for Crohn's disease in Japan and the USA since 2003 and 2010, respectively. This technique was designed to reduce the risk of anastomotic surgical recurrence. This study reviews the outcomes a decade after the introduction of the Kono-S anastomosis to clinical practice.
  
  
  METHODS
  This study was conducted at five hospitals (four in Japan and one in the USA). A total of 187 patients in Japan (144 patients, group J) and the USA (43 patients, group US) who underwent Kono-S anastomosis for Crohn's disease between September 2003 and September 2011 were included.
  
  
  RESULTS
  With a median follow-up of 65 months, two surgical anastomotic recurrences have occurred in group J. Kaplan-Meier analysis showed that 5 and 10 years surgical recurrence-free survival rate was 98.6% in group J. No surgical anastomotic recurrences have been detected in group US with a median follow-up of 32 months. The Kono-S anastomosis was technically feasible and performed in all patients.
  
  
  CONCLUSIONS
  The Kono-S anastomosis appears to be safe and effective in reducing the risk of surgical recurrence in Crohn's disease.
authors.affiliation: Advanced Surgery Center, Sapporo Higashi Tokushukai Hospital, 3-1, N 33, E 14, Higashi-ku, Sapporo, Hokkaido, 065-0033, Japan. kono@toru-kono.com.
authors.forename: Toru
authors.initials: T
authors.lastname: Kono
authors.affiliation: Division of General Surgery, Department of Surgery, University of Washington Medical Center, Seattle, WA, USA.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Fichera
authors.affiliation: Department of Surgery, Fujita Health University, School of Medicine, Toyoake, Aichi, Japan.
authors.forename: Koutarou
authors.initials: K
authors.lastname: Maeda
authors.affiliation: Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
authors.forename: Yoshiharu
authors.initials: Y
authors.lastname: Sakai
authors.affiliation: Department of Infectious Diseases, Hiroshima University Hospital, Hiroshima, Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Ohge
authors.affiliation: Division of General Surgery, Department of Surgery, University of Washington Medical Center, Seattle, WA, USA.
authors.forename: Mukta
authors.initials: M
authors.lastname: Krane
authors.affiliation: Department of Surgery, Fujita Health University, School of Medicine, Toyoake, Aichi, Japan.
authors.forename: Hidetoshi
authors.initials: H
authors.lastname: Katsuno
authors.affiliation: Division of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, Asahikawa, Japan.
authors.forename: Mikihiro
authors.initials: M
authors.lastname: Fujiya
mesh_terms: D000293:Adolescent; D000328:Adult; D000714:Anastomosis, Surgical / Q000009:adverse effects / Q000379:methods; D003106:Colon / Q000601:surgery*; D003424:Crohn Disease / Q000517:prevention & control* / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007082:Ileum / Q000601:surgery*; D007564:Japan; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D055502:Secondary Prevention / Q000379:methods*; D014481:United States; D055815:Young Adult
keywords: Crohn’s disease; Kono-S anastomosis; Surgical recurrence