MEErKAT: MEsenteric Excision and Kono-s Anastomosis Trial

Which methods of ileocaecal surgery are better than others in helping to prevent the recurrence of Crohn's Disease?

“The MEErKAT Research Project will look for the recurrence of Crohn’s Disease, a year after ileocaecal resection surgery, to test if some types of surgery are better than the usual methods in preventing recurrence.”

Professor Steve Brown
Consultant Colorectal Surgeon - Sheffield Teaching Hospitals NHS Foundation Trust
Leading the research with The University of Sheffield Clinical Trials Research Unit

What the researchers will look at:

MEErKAT aims to find out whether 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. Previous research has shown that both these surgical methods are safe.

People who have a section of bowel removed due to Crohn’s, have both ends of the remaining bowel surgically joined together. Crohn’s comes back for many people, often near the join. The mesentery is an organ which holds the gut in place and supplies the bowel with blood, lymphatics, nerves and other essentials. Many surgeons feel the type of surgery used to remove mesentery and join bowel ends can affect the chances of further disease.

Mesenteric Excision removes more of the mesentery during surgery than is usual at present.

Kono-S Anastomosis repositions the mesentery during surgery, away from the join.

The project will take place in 12 hospitals in England, Scotland, Wales and Northern Ireland where people who need ileocaecal surgery may agree to participate. The type of surgery a person has will be decided by chance and will be:

  • Mesenteric Excision with the current join method
  • OR current mesentery method with Kono-S join
  • OR Mesenteric Excision with Kono-S join
  • OR current mesentery with current join methods.

During surgery a small tattoo is made to locate the join. The tattoo is only visible when the inside of the bowel is medically examined around a year later.

Researchers will study the data from participants and compare disease recurrence rates for each type of surgery. Where a participant unfortunately suffers a recurrence of Crohn’s, the researchers will look at which part of the join the disease has returned to. 

What the researchers think this might mean for people with Crohn’s and Colitis:

Half of all people receiving ileocaecal surgery for Crohn’s suffer a recurrence of the disease. This project aims to test if Mesenteric Excision and/or the Kono-S Join are better than the usual methods in preventing recurrence and if they are better, then use of these methods will help prevent post-operative recurrence of Crohn’s.