Anorectal Crohn' s Disease

被引:7
作者
Truong, Adam [1 ]
Zaghiyan, Karen [1 ]
Fleshner, Phillip [1 ]
机构
[1] Cedars Sinai Med Ctr, Div Colorectal Surg, 8737 Beverly Blvd,Suite 101, Los Angeles, CA 90048 USA
关键词
Anorectal; Anal; Crohn disease; IBD; Flstula; INFLAMMATORY-BOWEL-DISEASE; FISTULA-IN-ANO; PERIANAL FISTULAS; ADVANCEMENT FLAP; ANAL FISTULAS; ENDOANAL ULTRASOUND; NATURAL-HISTORY; MANAGEMENT; CLASSIFICATION; EPIDEMIOLOGY;
D O I
10.1016/j.suc.2019.08.012
中图分类号
R61 [外科手术学];
学科分类号
摘要
Medical treatment remains the mainstay of perianal disease management for CD; however, aggressive surgical management should be considered for severe or recurrent disease. In all cases of perianal CD, medical and surgical treatments should be used in tandem by a multidisciplinary team. Significant development has been made in the treatment of Crohn's-related fistulas, particularly minimally invasive options with recent clinical trials showing success with mesenchymal stem cell applications. Inevitably, some patients with severe refractory disease may require fecal diversion or proctectomy. When considering reversal of a diverting or end ileostomy, cessation of proctitis is the most important factor.
引用
收藏
页码:1151 / 1162
页数:12
相关论文
共 80 条
[1]   Modern Treatments and Stem Cell Therapies for Perianal Crohn's Fistulas [J].
Al-Maawali, Alghalya Khalid Sulaiman ;
Phuong Nguyen ;
Phang, P. Terry .
CANADIAN JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, 2016, 2016
[2]  
Alexander-Williams J, 1980, World J Surg, V4, P203
[3]   Predictors of Crohn's disease [J].
Beaugerie, L ;
Seksik, P ;
Nion-Larmurier, I ;
Gendre, JP ;
Cosnes, J .
GASTROENTEROLOGY, 2006, 130 (03) :650-656
[4]  
Beck DE, 2009, ASCRS MANUAL COLON R, P273
[5]   Preoperative MR imaging of anal fistulas: Does it really help the surgeon? [J].
Beets-Tan, RGH ;
Beets, GL ;
van der Hoop, AG ;
Kessels, AFH ;
Vliegen, RFA ;
Baeten, CGMI ;
van Engelshoven, JMA .
RADIOLOGY, 2001, 218 (01) :75-84
[6]   Advancement flap procedure in Crohn and non-Crohn perineal fistulas: a simple surgical approach [J].
Bessi, G. ;
Siproudhis, L. ;
l'Heritier, A. Merlini ;
Wallenhorst, T. ;
Le Balc'h, E. ;
Bouguen, G. ;
Brochard, C. .
COLORECTAL DISEASE, 2019, 21 (01) :66-72
[7]  
BEST WR, 1976, GASTROENTEROLOGY, V70, P439
[8]   Long-term Outcome of Perianal Fistulizing Crohn's Disease Treated With Infliximab [J].
Bouguen, Guillaume ;
Siproudhis, Laurent ;
Gizard, Emmanuel ;
Wallenhorst, Timothee ;
Billioud, Vincent ;
Bretagne, Jean-Francois ;
Bigard, Marc-Andre ;
Peyrin-Biroulet, Laurent .
CLINICAL GASTROENTEROLOGY AND HEPATOLOGY, 2013, 11 (08) :975-+
[9]   Surgery for adult Crohn's disease: what is the actual risk? [J].
Bouguen, Guillaume ;
Peyrin-Biroulet, Laurent .
GUT, 2011, 60 (09) :1178-1181
[10]   Nonfistulizing Perianal Crohn's Disease: Clinical Features, Epidemiology, and Treatment [J].
Bouguen, Guillaume ;
Siproudhis, Laurent ;
Bretagne, Jean-Francois ;
Bigard, Marc-Andre ;
Peyrin-Biroulet, Laurent .
INFLAMMATORY BOWEL DISEASES, 2010, 16 (08) :1431-1442