Introduction: Crohn's disease (CD) is a chronic inflammatory bowel disease, which affect the entire gastrointestinal tract. Treatment basis for CD is medication to control the inflammation and relieve the symptoms. CD patients often require surgery at some points of their lifetime for complications, treatment-resistant, and side effects of medication. However, the postoperative recurrences are common. To reduce the anastomotic troubles, several types of anastomosis were investigated. Kono-S anastomosis, an antimesenteric functional end-to-end handsewn anastomosis, was introduced in order to prevent the restenosis caused by the recurrence of CD in 2010. Kono-S anastomosis is expected lower susceptibility to mechanical distortions due to the stability provided by the "supporting column". We herein report the two cases of CD which was performed Kono-S anastomosis. The important of these cases are that Kono-S anastomosis is useful to prevent the restenosis caused by the recurrence. Case presentation: The first patient was 26-year-old man, who had suffered from CD for 9 years. Computed tomography (CT) showed inflammation and stenosis at ileocecum, fistula between terminal ileum and sigmoid colon, and 3cm of intraperitoneal abscess. We performed ileocecal resection and Kono-S anastomosis. The second patient was 25-year-old woman who had suffered from CD for 8 years. CT showed inflammation and stenosis at ileocecum, and retroperitoneal abscess. We performed ileocecal resection and Kono-S anastomosis. Both patients don't have the recurrence after surgery. Conclusion: Kono-S anastomosis may be effective for preventing the recurrence at anastomotic site in CD patients.

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