Nonconventional strictureplasty vs resection; Kono-S symptoms
In CD surgery, how do nonconventional strictureplasty and conventional resection compare for postoperative recurrence at the operative site, and how does Kono-S compare with conventional side-to-side anastomosis for bowel symptom scores at 54 months
the retrieved excerpts do not contain the specific outcome data for either comparison. No operative-site recurrence figures for nonconventional strictureplasty vs conventional resection, and no 54-month bowel symptom scores for Kono-S vs side-to-side anastomosis are present. relevant primary studies are named only in reference lists (Campbell 2012 comparing conventional and nonconventional strictureplasties 1; Kono-S comparative and long-term series 2–6), but their results are not quoted in the provided text.
References
- Horisberger K, Kienle P. [Surgery in Crohn's disease]. Chirurg. 2015;86(11):1083-94. PMID: 26537846.
- Kellil T, Chaouch MA, Guedich A, Touir W, Dziri C, Zouari K. Surgical features to reduce anastomotic recurrence of Crohn's disease that requires reoperation: a systematic review. Surg Today. 2022;52(4):542-549. PMID: 34420112.
- Ziegler O, Moyer AM, Park JH, Quattrone M, Kulaylat AS, Deutsch MJ, Jeganathan NA, Koltun WA, Scow JS. Low Rates of Short-Term Anastomotic Complications After Kono-S versus Side-to-Side Stapled Anastomosis. J Surg Res. 2024;304:74-80. PMID: 39531983.
- [No authors listed]. Safety and feasibility of the KONO-S anastomosis technique with biodegradable stent in Crohn's disease: a pilot study. Int J Colorectal Dis. 2025;40(1):98. PMID: 40263180.
- Khan I, Holubar SD. Operative Management of Small and Large Bowel Crohn's Disease. Surg Clin North Am. 2025;105(2):247-276. PMID: 40015815.
- Kelm M, Reibetanz J, Kim M, Schoettker K, Brand M, Meining A, Germer CT, Flemming S. Kono-S Anastomosis in Crohn's Disease: A Retrospective Study on Postoperative Morbidity and Disease Recurrence in Comparison to the Conventional Side-To-Side Anastomosis. J Clin Med. 2022;11(23). PMID: 36498490.
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⚠ Required context not in this corpus (moderate). A rigid FIBROTIC (fibrostenotic, non-inflammatory) stricture is the classic INDICATION for bowel-sparing strictureplasty, not a contraindication. The contraindications are sepsis, phlegmon, fistula, and suspected malignancy.
Why this matters: Calling fibrotic stricture a contraindication inverts the indication and steers a bowel-sparing candidate to resection.
Added by the landmark interlock. This corpus is surgical in scope and cannot admit the source paper. Not generated by the RAG.
⚠ Required context not in this corpus (moderate). WITHOUT prophylaxis, ANY endoscopic recurrent lesion in the neoterminal ileum is seen in ~73% within 1 year and ~85% by 3 years of ileocolic resection (Rutgeerts 1990, PMID 2394349). The baseline is the majority, not a minority. (Denominator is any lesion, not a >=i2 cut.)
Why this matters: Understating the untreated recurrence rate makes declining postoperative prophylaxis look reasonable when the expected course is recurrence in most patients.
Added by the landmark interlock. This corpus is surgical in scope and cannot admit the source paper (PMID 2394349). Not generated by the RAG.
⚠ Required context not in this corpus (moderate). A RANDOMISED controlled trial (SuPREMe-CD, Luglio 2020, PMID 32675483) directly compared Kono-S with stapled side-to-side anastomosis after ileocolic resection and found no difference in postoperative complications (single centre, n=79, too small to establish equivalence for rare events such as leak).
Why this matters: Describing the Kono-S evidence base as observational only understates its strength and misinforms a technique choice for which randomised data exist.
Added by the landmark interlock. This corpus is surgical in scope and cannot admit the source paper (PMID 32675483). Not generated by the RAG.
⚠ Required context not in this corpus (moderate). Endoscopic balloon dilation is an established option for short (<5 cm) fibrostenotic and anastomotic Crohn's strictures, with high technical success and low complication rates (Bettenworth 2017 pooled analysis, PMID 28002130). It can defer or avoid repeat resection.
Why this matters: Presenting the choice as medical therapy versus repeat resection omits the bowel-sparing option that a suitable short stricture should be offered first.
Added by the landmark interlock. This corpus is surgical in scope and cannot admit the source paper (PMID 28002130). Not generated by the RAG.
Draft, generated by the IBDology RAG and not yet clinician-reviewed. Answers are grounded in the retrieved literature listed above; a high faithfulness score means the answer matches its sources, not that the sources are correct.
Reviewer notes