Endoscopic fluorescence imaging for early assessment of anastomotic recurrence of Crohn's disease

1999 ◽  
Author(s):  
Serge R. Mordon ◽  
Vincent Maunoury ◽  
K. Geboes ◽  
Olivier Klein ◽  
P. Desreumaux ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Fluorescence Imaging ◽  
Early Assessment ◽  
Anastomotic Recurrence

scholarly journals Experiences with the Kono-S anastomosis in Crohn’s disease of the terminal ileum—a cohort study

2020 ◽  
Author(s):  
K. Horisberger ◽  
D. L. Birrer ◽  
A. Rickenbacher ◽  
M. Turina
Keyword(s):  
Cohort Study ◽  
Crohn’S Disease ◽  
Postoperative Complications ◽  
Crohn's Disease ◽  
Terminal Ileum ◽  
Ileocecal Resection ◽  
Anastomotic Recurrence ◽  
Short Term ◽  
Recurrence Rates

Abstract Purpose The most frequent long-term complication after ileocecal resection in Crohn’s disease is anastomotic recurrence and subsequent stenosis. Recurrence typically begins at the site of the anastomosis, raising the question of whether the surgical technique of the anastomosis could affect recurrence rates. Kono-S anastomosis is a hand-sewn antimesenteric functional end-to-end anastomosis that offers a wide lumen that is well accessible for endoscopic dilatation. The purpose of our study is to review the rate of postoperative complications almost 2 years after the introduction of this technique. Materials and methods This is a prospective single-center cohort study of all consecutive patients with Crohn’s disease undergoing ileocecal resection. Patients’ characteristics as well as specific data for the surgical procedure and short-term outcome were evaluated. Results Thirty patients were operated for Crohn’s disease of the terminal ileum (n = 24) or anastomotic recurrence (n = 6). Postoperative complications with a Clavien-Dindo Score ≥ IIIb were observed in three patients. One patient showed a hemorrhage and underwent surgical hemostasis. Two patients developed anastomotic leakage; in both cases, ileostomy was created after resection of the anastomosis. The median hospital stay was 9 days (IQR 7–12). A comparison with a historic group of conventionally operated patients of our hospital revealed no differences in short-term results except for the duration of surgery. Conclusion The Kono-S anastomosis is associated with acceptable short-term results, complications, and recurrence rates comparable with the established anastomotic techniques. Longer operation times are observed, but the few published studies concerning long-term recurrence are promising.

scholarly journals P646 Utilisation of indocyanine green fluorescence imaging for Crohn’s disease following intestinal resection

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S534-S534
Author(s):  
Y Duan ◽  
Y Li
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Indocyanine Green ◽  
Fluorescence Imaging ◽  
Intestinal Resection ◽  
Perioperative Outcomes ◽  
Green Fluorescence ◽  
Indocyanine Green Fluorescence ◽  
Indocyanine Green Fluorescence Imaging ◽  
The Impact

Abstract Background Growing evidences have shown that there are important advantages related to the utilisation of indocyanine green fluorescence imaging (ICG-FI) to reduce the risk of postoperative anastomotic leakage (AL) in colorectal surgery. However, the impact of ICG-FI on postoperative AL of Crohn’s disease (CD) following intestinal resection has not been investigated. Methods This is a retrospective study of consecutive CD patients who were treated with intestinal resection and anastomosis at a single institution between January 2017 and August 2019. The cohort was divided into 2 groups, those with ICG-FI compared with those without ICG-FI for intestinal resection. ICG was administered intravenously with a bolus of 5 mg, and the intestinal perfusion was evaluated by a SPY Elite system. Their baseline characteristics and perioperative outcomes were further analysed. Results No adverse reactions were recorded. Of the 88 CD patients who underwent intestinal resection, 36 patients underwent ICG-FI during intestinal resection, while 52 CD patients who underwent routine intestinal resection were from a prospectively maintained database. The 2 groups were similar in terms of patient demographics, immunosuppressive medication use, and the procedural factors. In patients with ICG-FI, poor perfusion of the bowel judged by ICG-FI led to additional intestinal resection in 25% (9/36). ICG-FI reduces the AL rate from 13.5% (7 leaks) of non-ICF-FI group to 8.3% (3 leaks) in ICG-FI group (p = 0.456). Forty-four (50%) patients had previous intestinal resection. Overall, 10 anastomotic leaks were identified (11.4% leak rate). There were 2 leaks (4.5%) detected in patients with no previous intestinal resection, compared with 8 leaks (18.2%) identified in patients with a history of previous intestinal resection (p = 0.044). The number of previous resections correlated with increasing risk for AL (correlation coefficient = 0.998). In univariate analysis, steroid use, CRP level and preoperative weight loss >10% in 6 months were independently associated with AL. Conclusion ICG-FI is applicable to intestinal resection for CD and may play a role in perfusion-related AL. A large prospective randomised trial should be warranted.

Surgical features to reduce anastomotic recurrence of Crohn’s disease that requires reoperation: a systematic review

Surgery Today ◽  
2021 ◽  
Author(s):  
Tarek Kellil ◽  
Mohamed Ali Chaouch ◽  
Arwa Guedich ◽  
Wassim Touir ◽  
Chadli Dziri ◽  
...  
Keyword(s):  
Systematic Review ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Anastomotic Recurrence

Response to Comment on “Surgical Prevention of Anastomotic Recurrence by Excluding Mesentery in Crohn's Disease

2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Gaetano Luglio ◽  
Nicola Imperatore ◽  
Francesca Paola Tropeano ◽  
Antonio Rispo
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Anastomotic Recurrence ◽  
Surgical Prevention

scholarly journals P082 Early assessment of ustekinumab for Crohn's disease: A chart review

2019 ◽  
Vol 114 (1) ◽  
pp. S22-S22
Author(s):  
Ruetsch Charles ◽  
Davis Tigwa ◽  
Clerie Jennifer ◽  
Allen Antuane ◽  
Izanec James ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Chart Review ◽  
Early Assessment

Crohn's disease and anastomotic recurrence: microvascular ischaemia and anastomotic healing in an animal model

1993 ◽  
Vol 80 (2) ◽  
pp. 226-229 ◽  
Author(s):  
M. J. Osborne ◽  
M. Hudson ◽  
C. Piasecki ◽  
A. P. Dhillon ◽  
A. A. M. Lewis ◽  
...  
Keyword(s):  
Animal Model ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Anastomotic Healing ◽  
Anastomotic Recurrence

scholarly journals P292 TGF-BETA1 AND IGF-1 AND ANASTOMOTIC RECURRENCE OF CROHN'S DISEASE AFTER ILEO-COLONIC RESECTION

2008 ◽  
Vol 2 (1) ◽  
pp. 90-91
Author(s):  
M. Scarpa ◽  
M. Bortolami ◽  
S. Morgan ◽  
A. Kotsafti ◽  
C. Ruffolo ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Colonic Resection ◽  
Anastomotic Recurrence
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