Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2021 Feb;73(1):149-156.
doi: 10.1007/s13304-020-00918-z. Epub 2021 Jan 6.

Anastomosis configuration and technique following ileocaecal resection for Crohn's disease: a multicentre study

Valerio Celentano  1   2   3 , Gianluca Pellino  4 , Antonino Spinelli  5   6 , Francesco Selvaggi  4 ; SICCR Current status of Crohn’s disease surgery collaborative; Valerio Celentano, Gianluca Pellino, Matteo Rottoli, Gilberto Poggioli, Giuseppe Sica, Mariano Cesare Giglio, Michela Campanelli, Claudio Coco, Gianluca Rizzo, Francesco Sionne, Francesco Colombo, Gianluca Sampietro, Giulia Lamperti, Diego Foschi, Ferdinando Ficari, Ludovica Vacca, Marta Cricchio, Francesco Giudici, Lucio Selvaggi, Guido Sciaudone, Roberto Peltrini, Andrea Manfreda, Luigi Bucci, Raffaele Galleano, Omar Ghazouani, Luigi Zorcolo, Simona Deidda, Angelo Restivo, Andrea Braini, Francesca Di Candido, Matteo Sacchi, Michele Carvello, Stefania Martorana, Giovanni Bordignon, Imerio Angriman, Angela Variola, Mirko Di Ruscio, Giuliano Barugola, Andrea Geccherle, Francesca Paola Tropeano, Gaetano Luglio, Marta Tanzanu, Diego Sasia, Marco Migliore, Maria Carmela Giuffrida, Enrico Marrano, Gianluigi Moretto, Harmony Impellizzeri, Gaetano Gallo, Giuseppina Vescio, Giuseppe Sammarco, Giovanni Terrosu, Giacomo Calini, Andrea Bondurri, Anna Maffioli, Gloria Zaffaroni, Andrea Resegotti, Massimiliano Mistrangelo, Marco Ettore Allaix, Fiorenzo Botti, Matteo Prati, Luigi Boni, Serena Perotti, Michela Mineccia, Antonio Giuliani, Lucia Romano, Giorgio Maria Paolo Graziano, Luigi Pugliese, Andrea Pietrabissa, GianGaetano Delaini, Antonino Spinelli, Francesco Selvaggi; , on behalf of the Italian Society of Colorectal Surgery SICCR
Affiliations
Observational Study

Anastomosis configuration and technique following ileocaecal resection for Crohn's disease: a multicentre study

Valerio Celentano et al. Updates Surg. 2021 Feb.

Abstract

A limited ileocaecal resection is the most frequently performed procedure for ileocaecal CD and different anastomotic configurations and techniques have been described. This manuscript audited the different anastomotic techniques used in a national study and evaluated their influence on postoperative outcomes following ileocaecal resection for primary CD. This is a retrospective, multicentre, observational study promoted by the Italian Society of Colorectal Surgery (SICCR), including all adults undergoing elective ileocaecal resection for primary CD from June 2018 May 2019. Postoperative morbidity within 30 days of surgery was the primary endpoint. Postoperative length of hospital stay (LOS) and anastomotic leak rate were the secondary outcomes. 427 patients were included. The side to side anastomosis was the chosen configuration in 380 patients (89%). The stapled anastomotic (n = 286; 67%), techniques were preferred to hand-sewn (n = 141; 33%). Postoperative morbidity was 20.3% and anastomotic leak 3.7%. Anastomotic leak was independent of the type of anastomosis performed, while was associated with an ASA grade ≥ 3, presence of perianal disease and ileocolonic localization of disease. Four predictors of LOS were identified after multivariate analysis. The laparoscopic approach was the only associated with a reduced LOS (p = 0.017), while age, ASA grade ≥ 3 or administration of preoperative TPN were associated with increased LOS. The side to side was the most commonly used anastomotic configuration for ileocolic reconstruction following primary CD resection. There was no difference in postoperative morbidity according to anastomotic technique and configuration. Anastomotic leak was associated with ASA grade ≥ 3, a penetrating phenotype of disease and ileo-colonic distribution of CD.

Keywords: Colorectal surgery; Crohn’s disease; Ileocaecal resection; Inflammatory bowel disease; National audit.

PubMed Disclaimer

References

    1. Pellino G, Keller DS, Sampietro GM, Angriman I, Carvello M, Celentano V, Colombo F, Di Candido F, Laureti S, Luglio G, Poggioli G, Rottoli M, Scaringi S, Sciaudone G, Sica G, Sofo L, Leone S, Danese S, Spinelli A, Delaini G, Selvaggi F, Italian Society of Colorectal Surgery SICCR (2020) Inflammatory bowel disease position statement of the Italian society of colorectal surgery (SICCR): Crohn’s disease. Tech Coloproctol. https://doi.org/10.1007/s10151-020-02183-z ([Epub ahead of print] Review) - DOI - PubMed
    1. Feng JS, Li JY, Yang Z, Chen XY, Mo JJ, Li SH (2018) Stapled side-to-side anastomosis might be benefit in intestinal resection for Crohn’s disease: a systematic review and network meta-analysis. Med (Baltim) 97(15):e0315. https://doi.org/10.1097/MD.0000000000010315 - DOI
    1. Bemelman WA, Warusavitarne J, Sampietro GM, Serclova Z, Zmora O, Luglio G, de van BuckOverstraeten A, Burke JP, Buskens CJ, Colombo F, Dias JA, Eliakim R, Elosua T, Gecim IE, Kolacek S, Kierkus J, Kolho KL, Lefevre JH, Millan M, Panis Y, Pinkney T, Russell RK, Shwaartz C, Vaizey C, Yassin N, D’Hoore A (2018) ECCO-ESCP consensus on surgery for Crohn’s Disease. J Crohns Colitis 12(1):1–16. https://doi.org/10.1093/ecco-jcc/jjx061 - DOI - PubMed
    1. Ghoneima AS, Flashman K, Dawe V, Baldwin E, Celentano V (2019) High risk of septic complications following surgery for Crohn’s disease in patients with preoperative anaemia, hypoalbuminemia and high CRP. Int J Colorectal Dis 34(12):2185–2188 - DOI
    1. Rosenfeld G, Qian H, Bressler B (2013) The risks of post-operative complications following pre-operative infliximab therapy for Crohn’s disease in patients undergoing abdominal surgery: a systematic review and meta-analysis. J Crohns Colitis 7(11):868–877 - DOI

Publication types

MeSH terms

LinkOut - more resources