TY  - JOUR
AB  - The purpose of this study is to demonstrate that repetitive minor surgical procedures allow for a high rate of permanent closure of perianal fistulas in patients with Crohn’s disease (CD). Patients with perianal fistulizing CD (PFCD) who underwent perianal surgery at the University Hospital of Muenster between 2003 and 2018 were assessed for fistula characteristics and surgical procedures. We included 45 patients (m:f = 28:17) with a mean age of 27 years at first fistula appearance. Of these, 49% suffered from a complex fistula. An average of 4.2 (1–14) procedures were performed, abscess incisions and fistula seton drainages included. Draining setons were left in place for 5 (1–54) months, until fistula closure. Final surgical techniques were fistulotomy (31.1%), seton removal with sustained biological therapy (26.7%), Anal Fistula Plug (AFP) (17.8%), Over-The Scope-Clip proctology (OTSC) (11.1%), and mucosa advancement flap (4.4%). In 8.9% of cases, the seton was kept as permanent therapy. The time from first to last surgery was 18 (0–182) months and the median follow-up time after the last surgery was 90 (15–200) months. The recurrence rate was 15.5% after 45 (17–111) months. Recurrent fistulas healed after another 1.86 (1–2) surgical re-interventions. The final success rate was 80%. Despite biological treatment, PFCD management remains challenging. However, by repeating minor surgical interventions over a prolonged period of time, high permanent healing rates can be achieved.
AU  - Merten, Jennifer
AU  - Eichelmann, Ann-Kathrin
AU  - Mennigen, Rudolf
AU  - Flammang, Isabelle
AU  - Pascher, Andreas
AU  - Rijcken, Emile Jan Marie
DA  - 2021-10-14
KW  - Crohn’s disease
KW  - perianal fistula
KW  - complex fistula
KW  - seton drainage
KW  - anal fistula plug
KW  - OTSC
LA  - eng
N1  - Journal of Clinical Medicine 10 (2021) 20, 4721, 1-13
N1  - Finanziert durch den Open-Access-Publikationsfonds der Westfälischen Wilhelms-Universität Münster (WWU Münster).
PY  - 2021-10-14
TI  - Minor Sphincter Sparing Surgery for Successful Closure of Perianal Fistulas in Patients with Crohn’s Disease
UR  - https://nbn-resolving.org/urn:nbn:de:hbz:6-15059444741
Y2  - 2024-11-22T10:06:15
ER  -