| Theme |
Surgical therapy for Crohn's disease -- Essentials for physician |
| Title |
Surgical treatment for perianal Crohn's disease |
| Author |
Kitaro Futami |
Department of Surgery, Fukuoka University, Chikushi Hospital |
| Author |
Daijiro Higashi |
Department of Surgery, Fukuoka University, Chikushi Hospital |
| Author |
Yuji Egawa |
Department of Surgery, Fukuoka University, Chikushi Hospital |
| Author |
Yukiko Ishibashi |
Department of Surgery, Fukuoka University, Chikushi Hospital |
| Author |
Takashige Tomiyasu |
Department of Surgery, Fukuoka University, Chikushi Hospital |
| Author |
Ryo Futatsuki |
Department of Surgery, Fukuoka University, Chikushi Hospital |
| Author |
Toshimi Sakai |
Department of Surgery, Fukuoka University, Chikushi Hospital |
| Author |
Koji Mikami |
Department of Surgery, Fukuoka University, Chikushi Hospital |
| Author |
Takafumi Maekawa |
Department of Surgery, Fukuoka University, Chikushi Hospital |
| [ Summary ] |
Perianal lesions are frequently complicated with Crohn's disease (CD). These complications include fistula, absesses, anal ulcers, skin tags, anal strictures and carcinoma. Perianal fistula are the most commonly observed condition and exhibit multiple incidence and intratable characteristics. Perianal fistula are treated with medical therapies such as antibiotics, immunosuppressants or infiximab, however it is difficult to maintain long term remission. Types of surgical therapy selected include conventional fistulotomy, seton drainage and anorectal amputation. After conventional fistulotomy, recurrence is frequent and there is a risk of anal sphincter damage. Seton drainage is the preferred treatment to improve symptoms. The optimal treatment for perianal fistula associated with CD remains controversial. The primary goal of treatment is to avoid relapses and improre symptoms to achieve the best quality of life.
It is thought that, for treatment of perianal lesions associated with CD, on going careful management is important to control intestinal disease and long term maintain anal function. |