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Surgery for Crohn's anal fistulas
A Sugita1, K Koganei, H Harada
1Second Department of Surgery, Yokohama City University Hospital (Urafune), Japan.
Journal of Gastroenterology
|November 1, 1995
Summary
Crohn's anal fistulas occur in over half of patients. Seton treatment shows high efficacy, particularly for intersphincteric fistulas and in patients with intestinal Crohn's disease remission.
Area of Science:
- Gastroenterology
- Colorectal Surgery
Background:
- Anal fistulas are a common complication of Crohn's disease, impacting patient quality of life.
- The incidence and characteristics of anal fistulas vary depending on the location of intestinal involvement in Crohn's disease.
Purpose of the Study:
- To analyze the features of anal fistulas in patients with Crohn's disease.
- To evaluate the efficacy of seton treatment for Crohn's anal fistulas.
Main Methods:
- Retrospective analysis of 119 patients with Crohn's disease and anal fistulas.
- Evaluation of seton treatment (non-cutting, long-term drainage) in 21 patients.
- 16-month follow-up to assess treatment outcomes, including recurrence and continence.
Main Results:
- Anal fistulas were present in 56% of Crohn's disease patients.
- Intractable fistulas were more common in colitis and ileocolitis compared to ileitis.
- Seton treatment achieved good results in 81% of patients, with no recurrence in those who had setons removed; anal continence was preserved in all patients.
Conclusions:
- Anal fistulas associated with Crohn's ileitis may be more easily treated than those with colitis or ileocolitis.
- Seton treatment is effective for intersphincteric and transsphincteric fistulas, especially in patients with controlled intestinal Crohn's disease.