Over the years, many scholars devoted to the relationship between different anastomotic configuration and the outcomes of postoperative. With the larger luminal diameter, SSSA was thought theoretically to be more effective than HEEA. SSSA and HEEA are universally used to restore the continuity of intestinal tract after intestinal resection. Since the extensive application of gastrointestinal stapler, CD patients with intestinal anastomosis were more used of stapled side-to-side anastomosis (SSSA) or stapled end-to-side anastomosis (SESA), but traditional handsewn anastomosis is still used in somewhere of the world, such as handsewn end-to-end anastomosis (HEEA). Before instrumental anastomosis was widely application, those anastomotic configurations mentioned above were mainly performed by hand-fit, handsewn anastomosis. In addition, the side-to-side anastomosis can significantly reduce the incidence of postoperative complications, hospital stay and medical costs, and the intestinal function recovered faster in patients with side-to-side anastomosis. Although side-to-side anastomosis compared to other anastomosis (end-to-end, end-to-side) for the risk of CD relapse were remains controversial, many studies suggested that side-to-side anastomosis can reduce the anastomotic recurrence and the reoperation rate in postoperative patients. This may be related to a variety of factors, such as the direction of anastomosis was consistent with the movement of intestine, in which the intestinal contents pass through smoothly and resulting in less intestinal contents accumulated near the anastomotic site. Theoretically, the isoperistaltic oriented side-to-side anastomosis can significantly reduce the postoperative anastomotic recurrence of CD. In accordance with the proximal-distal bowel peristalsis direction, side-to-side anastomosis was divided into 2 subtypes, antiperistaltic and isoperistaltic orientation. Growing interest has being raised for the effect of anastomosis on postoperative outcomes recently.Īnastomosis for intestinal resection generally includes proximal-distal bowel side-to-side anastomosis, end-to-end anastomosis, and end-to-side anastomosis. It is believed that the anastomotic technique affects the surgical outcomes such as postoperative complications, recurrence, reoperation, and so on. Surgical techniques such as anastomosis used in the intestinal resection are important strategies for the surgical treatment of CD. About 80% CD patients will require surgery during their lifetime, about 15% to 20% will require surgery within the first year after diagnosis. Although great progress has been made in the medical therapy for CD, surgery remains plays an important role in its management, especially for failure of medication or complications, such as stricture, abscess, fistula, haemorrhage, or malignant transformation. It is characterized by a relapsing transmural bowel inflammation, which can mostly affect the terminal ileum and the proximal colon although any section of the gastrointestinal tract can be involved. Crohn's disease (CD) is one kind of inflammatory bowel disease related to an autoimmune disorder.
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