Surgical Treatment for perianal Crohn's disease

D. Gan, Wei Jin, Ying Li, Chang-Peng Han, Zhen-yi Wang
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Abstract

Crohn's disease (CD) is an inflammatory disease that occurs in unexplained gastrointestinal mucosa. Anal fistula is a common complication of CD. Anal fistula accounts for 15% of patients with ileocolonic CD, and 92% of CD patients with colon and rectum involvement have anal fistula. Although perianal CD is an anorectal benign disease, it significantly affects the patients' quality of life. Medical and surgical management are two major treatment approaches for Crohn's anal fistula. Drug treatment includes antibiotics, immunological agents, and biological agents. Nearly 30% of patients with CD anal fistula can be cured by standard medical treatment, and 70% need surgical intervention. The purpose of the current surgical treatment is to alleviate local symptoms and protect the anal sphincter function. The surgical treatment of Crohn's anal fistula depends largely on the type of anal fistula, the relationship with the sphincter, and whether it is in the remission of CD.
肛周克罗恩病的外科治疗
克罗恩病(CD)是一种发生在不明原因的胃肠道粘膜的炎症性疾病。肛瘘是CD的常见并发症,肛瘘占回肠结肠CD患者的15%,累及结肠直肠的CD患者中有92%存在肛瘘。虽然肛周CD是一种肛肠良性疾病,但它显著影响患者的生活质量。内科治疗和外科治疗是克罗恩肛瘘的两种主要治疗方法。药物治疗包括抗生素、免疫制剂和生物制剂。近30%的CD肛瘘患者可以通过标准的药物治疗治愈,70%的患者需要手术干预。目前手术治疗的目的是缓解局部症状,保护肛门括约肌功能。克罗恩肛瘘的手术治疗在很大程度上取决于肛瘘的类型、与括约肌的关系以及是否处于CD缓解期。
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