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Review
. 2014 Oct 7;20(37):13205-10.
doi: 10.3748/wjg.v20.i37.13205.

Treatment of peri-anal fistula in Crohn's disease

Giuseppe S Sica  1 , Sara Di Carlo  1 , Giorgia Tema  1 , Fabrizio Montagnese  1 , Giovanna Del Vecchio Blanco  1 , Valeria Fiaschetti  1 , Giulia Maggi  1 , Livia Biancone  1
Affiliations
Review

Treatment of peri-anal fistula in Crohn's disease

Giuseppe S Sica et al. World J Gastroenterol. .

Abstract

Anal fistulas are a common manifestation of Crohn's disease (CD). The first manifestation of the disease is often in the peri-anal region, which can occur years before a diagnosis, particularly in CD affecting the colon and rectum. The treatment of peri-anal fistulas is difficult and always multidisciplinary. The European guidelines recommend combined surgical and medical treatment with biologic drugs to achieve best results. Several different surgical techniques are currently employed. However, at the moment, none of these techniques appear superior to the others in terms of healing rate. Surgery is always indicated to treat symptomatic, simple, low intersphincteric fistulas refractory to medical therapy and those causing disabling symptoms. Utmost attention should be paid to correcting the balance between eradication of the fistula and the preservation of fecal continence.

Keywords: Anal fistula treatment; Crohn’s disease; Fistula; Perianal fistula; Seton; Surgery; Surgical treatment.

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