title: [Surgical treatment of anal fistulas in Crohn's disease].
abstract: The treatment of transsphincteric anal fistulas in Crohn's disease is a balance between the elimination of the sepsis and the functional outcome. Loose setons can be used as a preoperative drainage or chronic treatment. Fibrin glue and the anal fistula plug are methods with excellent functional outcomes, but the success rate varies. The endorectal advancement flap is considered to be the gold standard. Ligation of the intersphincteric fistula tract is promising. Proctectomy or proctocolectomy in combination with transposition flaps may be necessary. A success rate of 66-70% has been reported.
authors.affiliation: Medicinsk Afdeling, Regionshospitalet Silkeborg, Falkevej 1, 8600 Silkeborg, Denmark. tinheyc@rm.dk
authors.forename: Tina
authors.initials: T
authors.lastname: Heyckendorff-Diebold
authors.forename: Yasuko
authors.initials: Y
authors.lastname: Maeda
authors.forename: Steen
authors.initials: S
authors.lastname: Buntzen
authors.forename: Lilli
authors.initials: L
authors.lastname: Lundby
mesh_terms: D000714:Anastomosis, Surgical / Q000379:methods; D003094:Collagen / Q000627:therapeutic use; D003424:Crohn Disease / Q000150:complications / Q000473:pathology / Q000601:surgery* / Q000628:therapy; D013505:Digestive System Surgical Procedures / Q000379:methods; D004322:Drainage / Q000379:methods; D015718:Fibrin Tissue Adhesive / Q000627:therapeutic use; D006801:Humans; D008026:Ligation; D019919:Prosthesis Implantation; D012003:Rectal Fistula / Q000209:etiology / Q000473:pathology / Q000601:surgery* / Q000628:therapy; D013524:Surgical Flaps; D013536:Suture Techniques
chemical_list: D015718:Fibrin Tissue Adhesive; D003094:Collagen