Application of Different Anastomotic Methods for a Patient with Crohn’n Disease: Long-term Endoscopic Appearances of Hand-sewn Versus Biofragmentable Anastomosis Ring Method
After resection for ileocecal or ileocolonic Crohn's disease (CD), anastomotic recurrence is common, and roughly one half of the cases who undergo hand-sewn anastomoses require further surgery for suture line recurrence. The other anastomoses methods, stapled anastomoses, had been compared with that of patients having hand-sewn anastomoses. But the type of anastomosis, whether stapled or hend-sewn, did not affect the rates of symptomatic or operative recurrence. A compression anastomosis device consisting of a biofragmentable anastomosis ring (VALTRACR) is used with new anastomosis methods, and no fragments remain in the anastomosis unlike with other anastomotic materials. There have been few reports regarding the employment of VALTRACR methods for anastomoses of patients with CD. We reported a 30-year-old male with a 14-year history of CD. In 1991, he was referred to our hospital for surgery because of stenoses of the ileum and terminal ileum, and underwent ileocecal resection. Ileocolic anastomosis was performed with a hand-sewn method. In 1996, the patient was referred to our hospital again for surgery because of an ileoileal fistula and multiple stenoses in the ileum and the anastomosis. Resection of the previous anastomosis was performed. Next, ileocolic anastomosis was performed using a VALTRACR method. Comparisons of the long-term appearance of two different anastomoses (one hand-sewn and the other done by VALTRACR methods) of the same portion of the intestine in the patient were reported herein.
