SELECTED OPERATIVE MANAGEMENT OF FISTULA-IN-ANO IN CROHNS-DISEASE

被引:27
作者
BAYER, I
GORDON, PH
机构
[1] SIR MORTIMER B DAVIS JEWISH HOSP, DEPT SURG, MONTREAL H3T 1E2, PQ, CANADA
[2] MCGILL UNIV, DEPT SURG, MONTREAL H3A 2T5, PQ, CANADA
关键词
FISTULA-IN-ANO; CROHNS DISEASE;
D O I
10.1007/BF02050138
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
PURPOSE: The operative management of patients with fistula-in-ano in the presence of Crohn's disease has been controversial. Our aim was to review the results of operative treatment in this clinical setting. METHODS: Twenty-eight such patients treated between 1976 and 1990 were reviewed. The duration of local symptoms, location of the Crohn's disease, medications, and previous operations were noted. An effort was made to classify the fistula-in-ano according to Parks' classification, but many fistulas were complicated and did not neatly fit into one of the described categories (intersphincteric 9, transsphincteric 10, complex 9). Patients underwent fistulotomy (three with a seton). RESULTS: Complete healing was achieved in 71.4 percent of cases with an average healing time of 3.5 months (range, 3 weeks-26 months). With an average follow-up of 71 months (range, 12 months-14 years), postoperative function was good in 20 (71.5 percent) patients. Of the remaining eight patients, five ultimately underwent total proctocolectomy because of the severity of their colorectal disease, one patient developed alteration of continence, and two patients developed stenosis. There were two recurrences, (one at nine months and one at six years). CONCLUSION: Operative treatment should be offered to selected patients with fistula-in-ano in the presence of Crohn's disease.
引用
收藏
页码:760 / 765
页数:6
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