Steffen Seyfried1, Alexander Herold2. 1. Department of Surgery, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany. 2. Deutsches End- und Dickdarmzentrum, Mannheim, Germany.
Abstract
BACKGROUND: Perianal fistulizing Crohn's disease is associated with severe symptoms such as pain, fecal incontinence, and a significant reduction in quality of life. RESULTS: In refractory cases, many patients face the decision of having a stoma and/or requiring proctectomy. In former years, the standard of care was a complete fistulectomy, bringing with it a high rate of continence disorders. Additionally, many patients received indefinite treatment, namely the placement of a seton to maintain surgical drainage. CONCLUSION: More recently, newer biologics, cell-based therapies as well as novel surgical techniques have been introduced, raising new hopes that outcomes can be improved upon.
BACKGROUND: Perianal fistulizing Crohn's disease is associated with severe symptoms such as pain, fecal incontinence, and a significant reduction in quality of life. RESULTS: In refractory cases, many patients face the decision of having a stoma and/or requiring proctectomy. In former years, the standard of care was a complete fistulectomy, bringing with it a high rate of continence disorders. Additionally, many patients received indefinite treatment, namely the placement of a seton to maintain surgical drainage. CONCLUSION: More recently, newer biologics, cell-based therapies as well as novel surgical techniques have been introduced, raising new hopes that outcomes can be improved upon.
Authors: D H Present; P Rutgeerts; S Targan; S B Hanauer; L Mayer; R A van Hogezand; D K Podolsky; B E Sands; T Braakman; K L DeWoody; T F Schaible; S J van Deventer Journal: N Engl J Med Date: 1999-05-06 Impact factor: 91.245
Authors: J R Cintron; H Abcarian; V Chaudhry; M Singer; S Hunt; E Birnbaum; M G Mutch; J Fleshman Journal: Tech Coloproctol Date: 2012-09-28 Impact factor: 3.781
Authors: Ilse Molendijk; Bert A Bonsing; Helene Roelofs; Koen C M J Peeters; Martin N J M Wasser; Gerard Dijkstra; C Janneke van der Woude; Marjolijn Duijvestein; Roeland A Veenendaal; Jaap-Jan Zwaginga; Hein W Verspaget; Willem E Fibbe; Andrea E van der Meulen-de Jong; Daniel W Hommes Journal: Gastroenterology Date: 2015-06-25 Impact factor: 22.682