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MEsenteric Excision and Kono-S Anastomosis Trial (MEErKAT)

We want to see if different types of joins (anastamoses) are better than current methods of ileocaecal surgery in helping to prevent the recurrence of Crohn’s Disease. 

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Background to the study

  • Surgery can be a life changing treatment for people with Crohn’s
  • During Crohn’s surgery a section of the bowel is removed and the ends of the remaining bowel are sewn back together
  • Sometimes even after surgery, symptoms of Crohn’s can come back
  • Crohn’s often returns near the surgical join in the bowel
  • The mesentery also plays a role in the recurrence of Crohn’s after surgery

What is the mesentery?

  • The mesentery is an organ which holds the gut in place and supplies the bowel with blood, lymphatics, nerves and other essentials
  • The amount of mesentery removed during surgery may impact the recurrence of Crohn’s

What is Kono-S?

  • Kono-S is a type of Anastomosis (a surgical connection)
  • It repositions the mesentery during surgery so it is away from the join

What is Mesenteric excision?

  • Mesenteric excision is the removal of some of the mesentery during surgery
  • Surgeons may either remove a small amount, or a large amount
  • Currently only a small amount of the mesentery is removed during surgery for Crohn’s
  • Some surgeons think that removing more of the mesentery will improve surgery for Crohn’s

What is the aim of MEErKAT?

We want to see if Mesenteric Excision or Kono-S anastomosis, or both, are better than current types of ileocaecal surgery in helping to prevent the recurrence of Crohn’s Disease. Participants will be randomly assigned to receive one of four surgery combinations (as part of the same procedure):

Mesenteric Excision with the current join method
Current mesentery method with Kono-S join
Mesenteric Excision with Kono-S join
Current mesentery with current join methods

  • We will look at the rate of Crohn’s recurrence in people who have each of these four combinations
  • We will look at which part of the join the disease returns to
  • We are also taking samples of the bowel and mesentery from some participants to help us understand Crohn’s
  • This will all help us to determine which surgery is best for people with Crohn’s

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We know it can be difficult to live with, or support someone living with these conditions. But you’re not alone. We provide up-to-date, evidence-based information and can support you to live well with Crohn’s or Colitis.

Our helpline team can help by:

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