MEsenteric Excision and Kono-S Anastomosis Trial (MEErKAT).



Crohn’s is a disease that makes the bowel red, swollen and painful. It is a lifelong disease. Some people get few flare-ups. Other people may have really bad and long-lasting symptoms. There is no cure for Crohn’s, but drugs can treat the symptoms. If the drugs do not work surgery may be needed. Whilst surgery can also stop symptoms for a long time, the disease can return. Further drugs and even further surgery may be needed. 

Many surgeons feel that the way the bowel and the tissue containing the blood and other vessels supplying the bowel (the mesentery) is removed and the way the healthy bowel ends are re-joined can affect the success of the surgery. 

The MEErKAT Study

Two changes to the way surgeons operate have been proposed. One involves taking out more of the mesentery and the other involves doing another type of bowel join. This is known as the Kono-S join. We know that they are safe, but we need to test that they are better than the usual method in stopping further disease. 

The steps of the Kono-S bowl join
The steps of the Kono-S bowl join

We want to ask people if they would let us carry out one or both of these methods. We will then see if they have made the chances of further disease less one year later. The type of surgery a person has will be decided by chance.

A summary of the four groups in the MEErKAT study
A summary of the four groups in the MEErKAT study

We also need to see why these new methods may work. Some clues may be found by looking at those who get further disease after surgery and seeing what part of the joint the disease has come back to. To try and understand what causes the different outcomes between methods, we will also do blood tests and take samples from different bowel areas before and after surgery to see how the immune system is altered after the different operations. 

Central Study Staff

Steven Brown

Chief Investigator

Sheffield Teaching Hospitals NHS Foundation Trust

Laura Hancock

Co-Chief Investigator

Manchester University NHS Foundation Trust

Daniel Hind

Trial Oversight

University of Sheffield

Jamie Hall

Study Manager

University of Sheffield

Liv Hawksworth Research Assistant University of Sheffield

Jack Rose

Trial Support Officer

University of Sheffield


Professor Stephen Walters

Senior Statistician

University of Sheffield

Professor Alan Lobo

Consultant Gastroenterologist

Sheffield Teaching Hospitals NHS Foundation Trust

Professor Mark Travis

Professor of Immunology

The University of Manchester

Mr William Waterworth

PPI representative


Ms Lucy Sibbald

PPI representative


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