The Journal of surgical research · 2025
Isoperistaltic Anastomosis Increases Neo-Terminal Ileum Intubation Rates in Crohn's Disease Patients.
СтатьяСравнительное исследованиеНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
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Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Thurm Tamar, Berman Galia, Hirsch Ayal, Deutsch Liat, Cohen Nathaniel Aviv, Leibovitzh Haim, Ron Yulia, Dvir Nadav, Itzkovitz Eran, Tulchinsky Hagit, Yuval Jonathan B, Kariv Yehuda, Lahat Guy, Maharshak Nitsan, Zemel Meir
Аннотация
INTRODUCTION: Side-to-side stapled ileocolonic anastomosis (ICA) is commonly used in Crohn's disease (CD). Antiperistaltic ICA (APICA) and isoperistaltic ICA (IPICA) alignments differ in ease of neo-terminal ileum (neo-TI) intubation, potentially impacting endoscopic follow-up. This study compares postsurgical neo-TI intubation feasibility between APICA and IPICA.
MATERIALS AND METHODS: We performed a retrospective analysis of CD patients (≥18 y) who underwent ileocolonic resection between 2010 and 2022 and completed ileocolonoscopy within 24 mo. Patients with non-APICA/IPICA anastomoses, ileostomy, and patients whose ileocolonoscopy report was unavailable were excluded.
RESULTS: We included 148 patients, (76.4% APICA and 23.6% IPICA). Groups were comparable in demographics, surgical factors, and postsurgical outcomes. Anastomotic disease recurrence (Rutgeerts score Ri ≥ 2b) was similar: 37.6% APICA versus 37.1% IPICA (P = 0.563). Excluding patients with anastomotic strictures and poor preparation, neo-TI intubation was successful in 87.4% of APICA versus 100% of IPICA (P = 0.038).
CONCLUSIONS: APICA and IPICA have similar safety and endoscopic recurrence rates. IPICA allows for easier neo-TI intubation with no intubation failure, improving endoscopic surveillance and management of CD.
MATERIALS AND METHODS: We performed a retrospective analysis of CD patients (≥18 y) who underwent ileocolonic resection between 2010 and 2022 and completed ileocolonoscopy within 24 mo. Patients with non-APICA/IPICA anastomoses, ileostomy, and patients whose ileocolonoscopy report was unavailable were excluded.
RESULTS: We included 148 patients, (76.4% APICA and 23.6% IPICA). Groups were comparable in demographics, surgical factors, and postsurgical outcomes. Anastomotic disease recurrence (Rutgeerts score Ri ≥ 2b) was similar: 37.6% APICA versus 37.1% IPICA (P = 0.563). Excluding patients with anastomotic strictures and poor preparation, neo-TI intubation was successful in 87.4% of APICA versus 100% of IPICA (P = 0.038).
CONCLUSIONS: APICA and IPICA have similar safety and endoscopic recurrence rates. IPICA allows for easier neo-TI intubation with no intubation failure, improving endoscopic surveillance and management of CD.