[Anal surgery in Crohn's disease. Clinical and functional results]

The aim of this study was to evaluate the results of anal surgery performed in 105 patients for perianal symptomatic complications of Crohn's disease. The patients were divided into 3 groups: group I: 45 patients with simple fistulae; group II: 53 patients with complex fistulae; group III: 7 patients with other symptomatic perianal lesions. All patients underwent a resection of their perianal lesions. Complete wound healing was obtained in 95 patients after a mean interval of 11 weeks. Satisfactory results persisted during a mean follow-up of 5 years. The functional results were clinically evaluated in 100 patients: 90 patients were asymptomatic, 6 patients complained of soiling and 4 patients noticed occasional incontinence for flatus and liquid stools. Anorectal function was studied by manometry in the last 31 patients who underwent surgery. Before surgery, the resting anal pressure and the maximal voluntary squeezing pressure were significantly lower than in control subjects. After surgery, there was no statistical difference between the pre- and postoperative results for both parameters. In conclusion, anal surgery in Crohn's disease is hazardous because of the complexity of lesions and preoperative anorectal dysfunction. However, the clinical and functional results obtained in our patients were satisfactory.