Background
Various types of anastomosis have been performed in Crohn’s disease (CD) patients to decrease re-operation due to the recurrence. This study was designed to compare outcome of functional end-to-end anastomosis (FEE) and hand-sewn end-to-end anastomosis (HEE) after intestinal resection in CD.

Material and Methods
Clinical records of 155 patients were reviewed who underwent initial intestinal resection for CD and were reconstructed with FEE (110 patients with 120 anastomoses) or HEE (45 patients with 49 anastomoses) between 1973 and 2011.

Result
Median age at the time of surgery, and the duration from onset of CD to the operation were 27 (15-55) and 5 (0-33) years in FEE group, and 28 (13-48) and 3 (0-21) years in HEE group. Ileoileal anastomosis was performed in 42 (35%) and 15 (31%) patients, ileocolic anastomosis in 70 (58%) and 22 (45%), and colorectal anastomosis in 8 (6%) and 12 (24%), in FEE and HEE groups, respectively.

Morbidity rate was 25% in FEE group, and 14% in HEE group. Cumulative re-operation rate due to the recurrence at the anastomotic site were 25% at 5-year, 60% at 10-year in FEE group, and 25% at 5-year, 55% at 10-year in HEE group. There were no differences in morbidity and re- operation rate between two groups.

Conclusion
Long-term outcome after FEE and HEE did not differ in terms of morbidity and re-operation rate. These results indicate that HEE could be a choice of reconstruction in CD.