Kono-S Anastomosis for Crohn's Disease: a Systemic Review, Meta-analysis, and Meta-regression

Overview

Journal Surg Today

Specialty General Surgery

Date 2020 Sep 7

PMID 32894346

Citations 15

Authors

Cheng Han Ng

Yip Han Chin

Snow Yunni Lin

Jeffery Wei Heng Koh

Bettina Lieske

Frederick Hong-Xiang Koh

Choon Seng Chong

Fung Joon Foo

Affiliations

Soon will be listed here.

Abstract

The Kono-S anastomosis was introduced in 2011 as an alternative anastomosis in Crohn's disease (CD) surgery. Since then, prevailing evidence of the favorable results of the Kono-S anastomosis has been published from around the world. We conducted this study to analyze the effectiveness of the Kono-S anastomosis, by searching Medline, Embase, CNKI, and google scholar. Binominal data were analyzed after Freeman-Tukey double-arcsine transformation. Comparative data were analyzed using the Mantel-Haenszel model for dichotomous outcomes and the mean difference for continuous outcomes. We identified 676 patients who underwent surgery with a Kono-S anastomosis. Surgical recurrence was pooled at an average of 0% (CI: 0.00-0.01) and a reduced mean Rutgeerts score of 1.375 (CI: 0.727-2.023) after Kono-S anastomosis. Endoscopic recurrence after sensitivity analysis was 5% (CI: 0.00-0.15). Complications were rare, with a 3% incidence of ileus (CI: 0.01-0.05), a 4% incidence of small bowel obstruction (CI: 0.01-0.10), a 1% incidence of an anastomotic leak incidence (CI: 0.00-0.03), and a 10% incidence of postoperative infection (CI: 0.03-0.20). Evidence from this meta-analysis favors the Kono-S anastomosis for CD patients, especially for ileocolic anastomosis. Thus, clinicians should consider the applicability of Kono-S anastomosis in respective institutions.

Citing Articles

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Anastomosis after Bowel Resection for Crohn's Disease: State of the Art Review.

Newton C, Fichera A Clin Colon Rectal Surg. 2025; 38(2):104-112.

PMID: 39944304 PMC: 11813605. DOI: 10.1055/s-0044-1786534.

New anti-mesenteric delta-shaped stapled anastomosis: Technical report with short-term postoperative outcomes in patients with Crohn's disease.

Lee J, Yoon Y, Lee H, Kim Y, Kim M, Kim C World J Gastrointest Surg. 2024; 16(8):2592-2601.

PMID: 39220078 PMC: 11362929. DOI: 10.4240/wjgs.v16.i8.2592.

Safety and effectivity of Kono-S anastomosis in Crohn's patients: a systematic review and Meta-analysis.

Cathomas M, Saad B, Taha-Mehlitz S, Vankayalapati D, El Ghazal N, Mourad M Langenbecks Arch Surg. 2024; 409(1):227.

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The Reduction of Anastomosis-Related Morbidity Using the Kono-S Anastomosis in Patients with Crohn's Disease: A Meta-Analysis.

Baloyiannis I, Perivoliotis K, Sarakatsianou C, Chatzinikolaou C, Tzovaras G J Clin Med. 2024; 13(9).

PMID: 38730990 PMC: 11084922. DOI: 10.3390/jcm13092461.

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