Abstract
A number of factors should be considered when performing an intestinal anastomosis
in the setting of surgery for Crohn's disease. Preoperative risk factors, such as
malnutrition, abdominal sepsis, and immunosuppressive medications, may increase the
risk of postoperative anastomotic complications and alter surgical decision-making.
The anatomical configuration and technique of constructing the anastomosis may have
an impact on postoperative function and risk of recurrence, particularly in the setting
of ileocolic resection, where the Kono-S anastomosis has gained popularity in recent
years. There may be circumstances in which it may be more appropriate to perform an
ostomy either without an anastomosis or to temporarily divert an anastomosis when
the risk of anastomotic complications is felt to be high. In the setting of total
abdominal colectomy or proctocolectomy for Crohn's colitis, restorative procedures
may appropriate in lieu of a permanent stoma in certain scenarios.
Keywords
Crohn's disease - anastomosis - Kono-S
