Does stapled functional end-to-end anastomosis affect recurrence of Crohn's disease after ileocolonic resection?

Background/aims: Crohn's disease is characterized by a high incidence of perianastomotic recurrence after ileocolonic resection. The influence of anastomotic configuration on the incidence of reoperation was evaluated in patients undergoing resection for Crohn's disease.

Methodology: 106 patients affected by ileocolonic Crohn's disease were divided in two groups: group I with a hand-sewn end-to-side or side-to-side isoperistaltic anastomosis (30 patients) and group II with functional end-to-end anastomosis made with linear staplers (76 patients).

Results: The morbidity was 4.7%: 3 complications and a postoperative death occurred in group I and two complications occurred in group II. There were 5 recurrences (16.7%) in the hand-sewn group and 2 recurrences (2.6%) in the stapled group, with a recurrence rate of 3.54 and 0.92, respectively.

Conclusions: Our non-randomized study suggests a better trend toward the functional stapled technique, in terms of recurrence rate. These observations need further investigation with randomized controlled trials, to compare the two different anastomotic procedures.