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. 2025 Apr 22;40(1):98.
doi: 10.1007/s00384-025-04885-y.

Safety and feasibility of the KONO-S anastomosis technique with biodegradable stent in Crohn's disease: a pilot study

Xiaolong Ge #  1 , Yujie Jin #  1 , Wei Liu  1 , Yifan Tong  1 , Zhe Wan  1 , Weilin Qi  1 , Wei Zhou  2 , Xiujun Cai  1
Affiliations

Safety and feasibility of the KONO-S anastomosis technique with biodegradable stent in Crohn's disease: a pilot study

Xiaolong Ge et al. Int J Colorectal Dis. .

Abstract

Background and aims: The KONO-S (antimesenteric functional end-to-end handsewn) anastomosis has been used for Crohn's disease (CD) recently, with its efficacy in reducing the risk of anastomotic surgical recurrence. However, the anastomotic leakage is also found in CD with this technique. This study aims to evaluate the safety and feasibility of the KONO-S anastomosis with biodegradable stent in CD.

Methods: We performed a study of 56 CD patients undergoing bowel resection by the KONO-S anastomosis technique with or without biodegradable stent. Postoperative complications, time to first flatus, time to first defecation, and healing of the anastomosis were recorded, especially in patients receiving biodegradable stent.

Result: The study included 24 CD patients receiving KONO-S anastomosis with biodegradable stent and 32 patients receiving normal KONO-S anastomosis. In patients with biodegradable stent, 8 patients received small bowel resection, 15 received ileocecal resection, and 1 received colectomy; the mean time for the new anastomosis technique was 15.8 ± 2.0 min. No stent-related complications were observed postoperatively. The time to first flatus and defecation was 2.3 ± 0.5 days and 3.7 ± 0.8 days in patients with biodegradable stent, respectively. All the stents degraded at almost 4-5 weeks after surgery. The colonoscopy showed that the healing condition of the anastomosis was good without any recurrence during 6-month follow-up in the stent group.

Conclusion: This is a pilot study that showed that the KONO-S anastomosis technique with biodegradable stent was safe and feasible in CD with lower risk of anastomotic complications and no serious adverse events.

Keywords: Anastomotic leakage; Biodegradable stent; Crohn’s disease; KONO-S anastomosis.

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Conflict of interest statement

Declarations. Ethics approval: This study was conducted according to the guidelines of Declaration of Helsinki, and approved by the Ethics Committee of Sir Run Run Shaw Hospital (No. 2023–630 - 01). Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Shape of the biodegradable stent
Fig. 2
Fig. 2
Operative images of the KONO-S anastomosis combined with the biodegradable intestinal stent (A–H)
See this image and copyright information in PMC

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