Related Experiment Video
Updated: Jul 17, 2026
08:49
Murine Ileocolic Bowel Resection with Primary Anastomosis
Published on: October 29, 2014
Preventing Crohn's recurrence, Kono-S and extended mesenteric excision: network meta-analysis category
Talia Shepherd1, Devansh Shah1,2, Joseph Do Woong Choi1,3
1Department of Colorectal Surgery, Westmead Hospital, Westmead, NSW, Australia.
Langenbeck'S Archives of Surgery
|July 15, 2026
Summary
Kono-S anastomosis (KSA) significantly reduces surgical recurrence in Crohn
Area of Science:
- Gastroenterology
- Surgical Innovation
- Inflammatory Bowel Disease Research
Background:
- Crohn's disease (CD) management often involves surgery for refractory cases or complications.
- New surgical techniques like Kono-S anastomosis (KSA) and extended mesenteric excision (EME) are emerging.
- The comparative effectiveness of these techniques in reducing CD recurrence is not well-established.
Purpose of the Study:
- To compare the efficacy of Kono-S anastomosis (KSA) versus other anastomosis techniques.
- To evaluate extended mesenteric excision (EME) against limited mesenteric excision (LME) for Crohn's disease.
- To assess the impact of these surgical approaches on surgical and endoscopic recurrence rates.
Main Methods:
- A systematic literature search was conducted across major databases (Medline, Embase, Cochrane Library, JBI EBP) up to January 2025.
- Included studies involved intestinal resection in CD patients undergoing at least two of four interventions: KSA, other anastomosis, EME, or LME.
- Bayesian network meta-analysis was employed to evaluate surgical recurrence at 5 years and endoscopic recurrence at 6-12 months.
Main Results:
- Thirteen studies (3 RCTs, 10 cohort studies; n=2,044) were analyzed.
- Kono-S anastomosis (KSA) showed a statistically significant reduction in surgical recurrence compared to other anastomosis techniques (OR 0.07).
- No significant difference in surgical recurrence was found between EME and LME, nor in endoscopic recurrence across any intervention groups.
Conclusions:
- Kono-S anastomosis (KSA) is associated with a lower risk of surgical recurrence in Crohn's disease patients compared to conventional anastomosis.
- Current evidence does not support a significant difference in surgical recurrence between extended mesenteric excision (EME) and limited mesenteric excision (LME).
- Further research is needed to clarify the role of EME versus LME and to confirm the long-term benefits of KSA on endoscopic recurrence.
More Related Videos
06:46Caudal-to-cranial Approach in Laparoscopic Right Hemicolectomy with Complete Mesocolon Excision and D3 Lymph Node Dissection
Published on: January 9, 2026
08:51Murine Appendectomy Model of Chronic Colitis Associated Colorectal Cancer by Precise Localization of Caecal Patch
Published on: August 24, 2019
Related Concept Videos
01:21Inflammatory Bowel Disease V: Surgical Management
Surgical interventions for inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn's disease, are essential in managing symptoms and addressing complications. The selection of surgical procedures is contingent upon the specific conditions and complications that stem from these illnesses.
Here are some common surgical interventions for IBD:
Here are some common surgical interventions for IBD:
01:25Inflammatory Bowel Disease III: Crohn's Disease
Crohn’s disease is a chronic, relapsing form of inflammatory bowel disease characterized by segmental, transmural inflammation that can affect any part of the gastrointestinal tract. Its pathogenesis arises from a combination of genetic susceptibility, environmental exposures, epithelial barrier dysfunction, and immune dysregulation. Together, these factors lead to an exaggerated immune response against components of the gut microbiome.Genetic and Environmental InfluencesMultiple genetic...
01:30Inflammatory Bowel Disease II: Crohn's Disease
Introduction
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by transmural...
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by transmural...
01:29Inflammatory Bowel Disease IV: Pharmacological Management
Upon diagnosis, managing Inflammatory Bowel Disease (IBD) involves addressing several crucial aspects. The primary goals include resting the bowel, correcting malnutrition, and providing symptomatic relief. Resting the bowel may consist of medications to reduce inflammation and promote healing. Correcting malnutrition is essential, often requiring dietary adjustments and nutritional supplements. Symptomatic relief aims to ease pain, diarrhea, and other discomforts in IBD.
Pharmacologic...
Pharmacologic...
01:30Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy
Various diagnostic tests are employed in the diagnostic process for Inflammatory Bowel Disease (IBD), particularly to differentiate between Crohn's disease and ulcerative colitis.
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the colonic...
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the colonic...
01:29Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents
Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel Disease...