P0585Long-term outcomes after Kono-S ileocaecal resection in paediatric Crohn’s disease: A single-centre prospective cohort

Background Children with Crohn’s disease (CD) frequently undergo ileocaecal resection (ICR), and anastomotic recurrence is common. In adults, published results on the Kono-S anastomosis are mixed. Evidence on how anastomotic configuration affects recurrence in paediatric patients remains scarce. We aimed to report single-centre outcomes of laparoscopically assisted Kono-S in children, focusing on long-term safety and on endoscopic and surgical recurrence. Methods We conducted a single-centre prospective observational cohort including all consecutive paediatric CD patients (N = 25) undergoing single-port laparoscopically assisted ICR with Kono-S between August 2022 and September 2025. Data were collected prospectively in a predefined institutional database, including demographics, perioperative parameters, complications (Clavien–Dindo), and endoscopic follow-up. Endoscopic recurrence was defined as Rutgeerts ≥i2. Results are reported as median (Q1–Q3) or n (%). Results Median age at surgery was 16.9 years (13.8–17.6); 13 (52%) were male. Paris classification: B2 in 13 (52%), B3 in 12 (48%). Procedures were elective in 14 (56%) and subacute in 11 (44%). Biologic therapy was used in 24/25 (96%); among treated patients, the interval from last dose to surgery was 7 days (3–14). Operative time was 170 min (152–203); Kono-S creation 56 min (50–64); length of stay 6 days (5–7). No ≥Clavien–Dindo complications occurred. Endoscopy was performed in 19/25 (76%) at 6 months (5–6): endoscopic recurrence (Ri ≥ 2) 5/19 (26%). No surgical recurrence was observed. Median follow-up was 29 months (11–33). Conclusion In this prospectively collected single-centre cohort, laparoscopically assisted Kono-S showed excellent short-term safety and low endoscopic recurrence with no surgical recurrence at follow-up. These findings suggest favourable outcomes in children and warrant confirmation in larger multicentre cohorts. Conflict of interest: Dr. Dotlacil, Vojtech: No conflict of interest Zarubova, Kristyna: No conflict of interest Mitrova, Katarina: Lecture fees/consultancy: Abbvie, Janssen, Eli-Lilly Schwarz, Jan: No conflict of interest Hradsky, Ondrej: Lectures/congress fees/consultancy from MSD, AbbVie, Takeda, Sandoz, Nutricia, Ferring, Pfizer, and Lilly. Skaba, Richard: No conflict of interest Bronsky, Jiri: Personal Fees: AbbVie, MSD, Nutricia, Nestlé Non-financial Support: AbbVie, MSD, Nutricia, Nestlé Rygl, Michal: No conflict of interest