AB075. SOH24AB_236. Kono-S anastomosis for ileocolic Crohn’s disease: a retrospective review

Background: The rate of recurrence of Crohn’s disease (CD) following ileocolic resection (ICR) is high. The Kono-S anastomosis technique has demonstrated promising results but is not yet mainstream practice. The purpose of this study was to analyse postoperative outcomes and rates of endoscopic recurrence following Kono-S anastomosis in a high-volume centre.

Methods: A retrospective single-centre study of all patients with ileocolic CD managed by ICR and Kono-S anastomosis over a 3-year period was performed. A standardised approach of reconstruction as described by Kono et al. in 2011 was utilised. Demographic, perioperative and postoperative data along with rates of endoscopic recurrence were recorded.

Results: Twenty-eight patients underwent ICR and Kono-S anastomosis for ileocolic CD during the study period. Laparoscopic (n=12), robotic (n=1) and open (n=15) approaches were utilised. The median inpatient length of stay was 5 days. Two patients (7.1%) required interventional radiology to drain collections in the postoperative period. Apart from this, no other major morbidities (Clavien-Dindo ≥3B) occurred in the postoperative period. No wound infections were recorded. There were no 30-day readmissions, reoperations or mortalities in the cohort. The median follow-up time was 12 months (range: 5–32 months) To date, no endoscopic recurrences of anastomotic CD have been recorded in patients reconstructed by the Kono-S technique.

Conclusions: In our study, the Kono-S anastomosis was demonstrated to be a safe and effective technique with low postoperative morbidity. It is highly encouraging that no endoscopic recurrences to date have been demonstrated. To our knowledge, this study represents the largest experience with this technique in Ireland.

Keywords: Anastomosis; Crohn’s disease (CD); ileocolic resection (ICR); Kono-S; recurrence