J Surg Tech Proced | Volume 3, Issue 1 | Research Article | Open Access

Novel Technique in Crohn's Surgery; End to End Single Sero-Muscular Manual Suture Excluding Mucosa

Mohamed Mahmood Nasr*

Department of Endoscopic and General Surgery, King Fahad Hospital, Saudi Arabia

*Correspondance to: Mohamed Mahmood Nasr 

Fulltext PDF

Abstract

Background: An optimal method performing intestinal anastomosis in patients with Crohn’s disease has not been widely accepted yet. The current research is proposing a novel hand-sew technique applied on end to end ileo-colic resection anastomosis cases.Methods: Between January 2012 and December 2017, 63 cases previously diagnosed as Crohn’s disease presented to the emergency department as fecal peritonitis secondary to ileo-caecal perforation or gangrene with or without abscess formation.
Results: Crohn's patients presented to emergency department with picture of acute abdomen secondary to perforated bowel were included in the study. All patients had pre-operative abdominal computerized tomography for diagnosis and post-operatively for follow up. Post-operatively seven patients had minor submucosal anastomotic dissection of dye that is contained within the subserosal layer. None of the patients needed additional surgery during their primary hospitalization nor needed surgical hospitalization during the long follow up stay.Discussion: There was no leakage from the anastomotic line in any of the study cases. Moreover the extended follow up has revealed no needed re-operation as any recurrent disease at the region of surgical anastomosis. Comparing the current research result to that from literature proves the proposed technique superior. Surgical anastomotic technique in Crohn’s disease is an important factor as patients with permanent end ileostomy seldom suffer from recurrence.Conclusion: Application of the proposed anastomotic technique upon Crohn’s cases is an extreme challenge that suggests the technique as potentially competent one in any intestinal anastomotic situation. The proposed surgical technique needs to be verified on larger sample.

Keywords:

Crohn&39;s disease; Single layer sero-muscular anastomosis; Ileo-ascending colon primary anastomosis; TPN

Citation:

Nasr MM. Novel Technique in Crohn's Surgery; End to End Single SeroMuscular Manual Suture Excluding Mucosa. J Surg Tech Proced. 2019; 3(1): 1025.

Subscribe to Our Newsletter