肠系膜
医学
吻合
克罗恩病
外科
回顾性队列研究
肠切除术
切除术
疾病
内科学
作者
Stefan D. Holubar,Jeremy M. Lipman,Scott R. Steele,Tairin Uchino,Eddy Lincango-Naranjo,Dávid Líška,Kristen A. Ban,David R. Rosen,Joshua Sommovilla,Emre Görgün,Hermann Keßler,Michael Valente,Tracy L. Hull
标识
DOI:10.1016/j.amjsurg.2023.10.050
摘要
The mesentery has recently been implicated in the pathophysiology of Crohn's disease (CD), and several techniques have been developed to target the mesentery to reduce its influence on recurrence. We aimed to describe short-term safety and feasibility after these approaches.This is a comparative, retrospective, single-center cohort study of consecutive CD patients undergoing primary or redo ileocolic resection from 2015 to 2022 with Kono-S anastomosis (KSA), extended mesenteric excision (EME) only, or both: mesenteric excision and exclusion (MEE).186 patients underwent KSA (n = 74), EME (n = 66), or MEE (n = 46). The groups had comparable baseline characteristics. The MEE group operative time was longer (median: 187 vs. KSA 170, EME 152 min, p < 0.01). Postoperatively, the groups had similar lengths of stay (median 4 days), readmissions (9.1 %), major postoperative complications (6.5 %), and anastomotic leaks (1.1 %).Targeting the mesentery with novel surgical approaches for ileocolic Crohn's disease was safe and feasible for short-term follow-up.
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