Impact of anastomosis type on postoperative recurrence after bowel resection for Crohn disease / 中华胃肠外科杂志

ABSTRACT

<p><b>OBJECTIVE</b>To determine whether side-to-side anastomosis(SSA) is associated with decreased recurrence after bowel resection for Crohn disease(CD) as compared to end-to-side anastomosis(ESA) or end-to-end anastomosis(EEA).</p><p><b>METHODS</b>Patients undergoing bowel resection for CD at the Jinling hospital of Nanjing University School of Medicine from 2002 to 2010 were studied retrospectively. Postoperative recurrence in patients with SSA was compared with that in patients with ESA or EEA.</p><p><b>RESULTS</b>A total of 94 patients underwent bowel resection for CD. Anastomosis type was SSA in 56 patients and ESA or EEA in 38. Postoperatively 52 patients underwent at least one endoscopic evaluation (28 SSA and 24 ESA or EEA). The postoperative cumulative endoscopic recurrence rate was 10.7% at 1 year and 46.4% at 2 years in the SSA group, and was 29.2% at 1 year and 66.7% at 2 year in the ESA/EEA group, the differences were statistically significant(Log-rank P=0.037). The postoperative cumulative clinical recurrence rate was 3.6% at 1 year and 8.9% at 2 years in the SSA group, and was 7.9% at 1 year and 21.1% at 2 year in the ESA/EEA group, the differences were statistically significant(Log-rank P=0.041).</p><p><b>CONCLUSION</b>Side-to-side anastomosis is associated with decreased symptomatic recurrence and endoscopic recurrence as compared to ESA or EEA.</p>