Antimesenteric cutback end‐to‐end isoperistaltic anastomosis (Sasaki‐Watanabe anastomosis) for Crohn's disease: Novel surgical technique and early results of surgical anastomotic recurrence

Abstract Background Antimesenteric cutback end‐to‐end isoperistaltic anastomosis (Sasaki‐Watanabe anastomosis; Sasaki‐W anastomosis), which was developed in our department, is a novel hand‐sewn anastomotic technique for Crohn's disease intended to prevent anastomotic stenosis and preserve the p...

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Main Authors: Kazuhiro Watanabe, Iwao Sasaki, Atsushi Kohyama, Hideyuki Suzuki, Minoru Kobayashi, Taiki Kajiwara, Hideaki Karasawa, Shinobu Ohnuma, Takashi Kamei, Michiaki Unno
Format: Article
Language:English
Published: Wiley 2021-07-01
Series:Annals of Gastroenterological Surgery
Subjects:
Online Access:https://doi.org/10.1002/ags3.12445
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author Kazuhiro Watanabe
Iwao Sasaki
Atsushi Kohyama
Hideyuki Suzuki
Minoru Kobayashi
Taiki Kajiwara
Hideaki Karasawa
Shinobu Ohnuma
Takashi Kamei
Michiaki Unno
author_facet Kazuhiro Watanabe
Iwao Sasaki
Atsushi Kohyama
Hideyuki Suzuki
Minoru Kobayashi
Taiki Kajiwara
Hideaki Karasawa
Shinobu Ohnuma
Takashi Kamei
Michiaki Unno
author_sort Kazuhiro Watanabe
collection DOAJ
description Abstract Background Antimesenteric cutback end‐to‐end isoperistaltic anastomosis (Sasaki‐Watanabe anastomosis; Sasaki‐W anastomosis), which was developed in our department, is a novel hand‐sewn anastomotic technique for Crohn's disease intended to prevent anastomotic stenosis and preserve the peripheral circulation. Aim The aim of the present study is to present the surgical technique of Sasaki‐W anastomosis and to assess the safety and the early results of the surgical anastomotic recurrence of Sasaki‐W anastomosis. Patients and Methods The present study was a single‐center retrospective cohort study. As an early‐period group, 13 patients with Crohn's disease, who were mainly selected from cases considered to be at high risk of recurrence, underwent 15 Sasaki‐W anastomoses from August 2009 to January 2012. As a late‐period group, 36 patients with Crohn's disease, who were selected regardless of risk factors, underwent 37 Sasaki‐W anastomoses from September 2016 to March 2020. The medical data including patient characteristics, surgical records, postoperative details, and surgical recurrences were assessed. Results There were no intraoperative complications. With a median follow‐up of 107 mo, surgical recurrence occurred in one patient at 106 mo after surgery in the early‐period group. The cumulative surgical recurrence‐free rate in the early‐period group was 100% at 5 y and 86% at 10 y after surgery. No patients required reoperation in the late‐period group. Conclusion Sasaki‐W anastomosis is safe and feasible. Although long‐term study is needed, this anastomotic technique can be a reasonable operative option for Crohn's disease.
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spelling doaj.art-8dfc5e15bebd4f6aa415d272a8ceaa122023-03-15T10:05:47ZengWileyAnnals of Gastroenterological Surgery2475-03282021-07-015452853710.1002/ags3.12445Antimesenteric cutback end‐to‐end isoperistaltic anastomosis (Sasaki‐Watanabe anastomosis) for Crohn's disease: Novel surgical technique and early results of surgical anastomotic recurrenceKazuhiro Watanabe0Iwao Sasaki1Atsushi Kohyama2Hideyuki Suzuki3Minoru Kobayashi4Taiki Kajiwara5Hideaki Karasawa6Shinobu Ohnuma7Takashi Kamei8Michiaki Unno9Department of Surgery Tohoku University Graduate School of Medicine Sendai JapanMiyagi Medical Check‐up Plaza Sendai JapanDepartment of Surgery Tohoku University Graduate School of Medicine Sendai JapanDepartment of Surgery Tohoku University Graduate School of Medicine Sendai JapanDepartment of Surgery Tohoku University Graduate School of Medicine Sendai JapanDepartment of Surgery Tohoku University Graduate School of Medicine Sendai JapanDepartment of Surgery Tohoku University Graduate School of Medicine Sendai JapanDepartment of Surgery Tohoku University Graduate School of Medicine Sendai JapanDepartment of Surgery Tohoku University Graduate School of Medicine Sendai JapanDepartment of Surgery Tohoku University Graduate School of Medicine Sendai JapanAbstract Background Antimesenteric cutback end‐to‐end isoperistaltic anastomosis (Sasaki‐Watanabe anastomosis; Sasaki‐W anastomosis), which was developed in our department, is a novel hand‐sewn anastomotic technique for Crohn's disease intended to prevent anastomotic stenosis and preserve the peripheral circulation. Aim The aim of the present study is to present the surgical technique of Sasaki‐W anastomosis and to assess the safety and the early results of the surgical anastomotic recurrence of Sasaki‐W anastomosis. Patients and Methods The present study was a single‐center retrospective cohort study. As an early‐period group, 13 patients with Crohn's disease, who were mainly selected from cases considered to be at high risk of recurrence, underwent 15 Sasaki‐W anastomoses from August 2009 to January 2012. As a late‐period group, 36 patients with Crohn's disease, who were selected regardless of risk factors, underwent 37 Sasaki‐W anastomoses from September 2016 to March 2020. The medical data including patient characteristics, surgical records, postoperative details, and surgical recurrences were assessed. Results There were no intraoperative complications. With a median follow‐up of 107 mo, surgical recurrence occurred in one patient at 106 mo after surgery in the early‐period group. The cumulative surgical recurrence‐free rate in the early‐period group was 100% at 5 y and 86% at 10 y after surgery. No patients required reoperation in the late‐period group. Conclusion Sasaki‐W anastomosis is safe and feasible. Although long‐term study is needed, this anastomotic technique can be a reasonable operative option for Crohn's disease.https://doi.org/10.1002/ags3.12445antimesenteric cutback end‐to‐end isoperistaltic anastomosisCrohn's diseaseSasaki‐W anastomosisSasaki‐Watanabe anastomosissurgical technique
spellingShingle Kazuhiro Watanabe
Iwao Sasaki
Atsushi Kohyama
Hideyuki Suzuki
Minoru Kobayashi
Taiki Kajiwara
Hideaki Karasawa
Shinobu Ohnuma
Takashi Kamei
Michiaki Unno
Antimesenteric cutback end‐to‐end isoperistaltic anastomosis (Sasaki‐Watanabe anastomosis) for Crohn's disease: Novel surgical technique and early results of surgical anastomotic recurrence
Annals of Gastroenterological Surgery
antimesenteric cutback end‐to‐end isoperistaltic anastomosis
Crohn's disease
Sasaki‐W anastomosis
Sasaki‐Watanabe anastomosis
surgical technique
title Antimesenteric cutback end‐to‐end isoperistaltic anastomosis (Sasaki‐Watanabe anastomosis) for Crohn's disease: Novel surgical technique and early results of surgical anastomotic recurrence
title_full Antimesenteric cutback end‐to‐end isoperistaltic anastomosis (Sasaki‐Watanabe anastomosis) for Crohn's disease: Novel surgical technique and early results of surgical anastomotic recurrence
title_fullStr Antimesenteric cutback end‐to‐end isoperistaltic anastomosis (Sasaki‐Watanabe anastomosis) for Crohn's disease: Novel surgical technique and early results of surgical anastomotic recurrence
title_full_unstemmed Antimesenteric cutback end‐to‐end isoperistaltic anastomosis (Sasaki‐Watanabe anastomosis) for Crohn's disease: Novel surgical technique and early results of surgical anastomotic recurrence
title_short Antimesenteric cutback end‐to‐end isoperistaltic anastomosis (Sasaki‐Watanabe anastomosis) for Crohn's disease: Novel surgical technique and early results of surgical anastomotic recurrence
title_sort antimesenteric cutback end to end isoperistaltic anastomosis sasaki watanabe anastomosis for crohn s disease novel surgical technique and early results of surgical anastomotic recurrence
topic antimesenteric cutback end‐to‐end isoperistaltic anastomosis
Crohn's disease
Sasaki‐W anastomosis
Sasaki‐Watanabe anastomosis
surgical technique
url https://doi.org/10.1002/ags3.12445
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