Healing of Transsphincteric Perianal Fistulas in Crohn's Disease Using a New Technique |
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| Authors: | Annette M Winter MD Peter A Banks MD James G Petros MD |
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| Institution: | Department of Medicine, Division of Gastroenterology, Department of Surgery, St. Elizabeth's Hospital and Tuft's University School of Medicine, Boston, Massachusetts |
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| Abstract: | Objectives : Transsphincteric perianal fistulas in Crohn's disease are often refractory to medical therapy and difficult to treat surgically. Our objective was to determine whether a new method of anal fistulotomy was effective in healing these fistulas. Methods : In this new method, the internal opening of the fistula tract was displaced distally to the region of the anal mucosa in 26 patients with Crohn's disease. Results : Healing was achieved within 5 weeks of surgery in 45/49 (92%) of the fistulas and was not influenced by perioperative medication, site of preexisting Crohn's disease, or condition of the rectum. There has been no alteration of preoperative continence. Conclusions : We conclude that this method is highly effective in treating transsphincteric perianal fistulas in Crohn's disease. |
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