title: Treatment of peri-anal fistula in Crohn's disease.
abstract: Anal fistulas are a common manifestation of Crohn's disease (CD). The first manifestation of the disease is often in the peri-anal region, which can occur years before a diagnosis, particularly in CD affecting the colon and rectum. The treatment of peri-anal fistulas is difficult and always multidisciplinary. The European guidelines recommend combined surgical and medical treatment with biologic drugs to achieve best results. Several different surgical techniques are currently employed. However, at the moment, none of these techniques appear superior to the others in terms of healing rate. Surgery is always indicated to treat symptomatic, simple, low intersphincteric fistulas refractory to medical therapy and those causing disabling symptoms. Utmost attention should be paid to correcting the balance between eradication of the fistula and the preservation of fecal continence.
authors.affiliation: Giuseppe S Sica, Sara Di Carlo, Giorgia Tema, Giulia Maggi, Department of Surgery, Tor Vergata University Hospital, Rome 00133, Italy.
authors.forename: Giuseppe S
authors.initials: GS
authors.lastname: Sica
authors.affiliation: Giuseppe S Sica, Sara Di Carlo, Giorgia Tema, Giulia Maggi, Department of Surgery, Tor Vergata University Hospital, Rome 00133, Italy.
authors.forename: Sara
authors.initials: S
authors.lastname: Di Carlo
authors.affiliation: Giuseppe S Sica, Sara Di Carlo, Giorgia Tema, Giulia Maggi, Department of Surgery, Tor Vergata University Hospital, Rome 00133, Italy.
authors.forename: Giorgia
authors.initials: G
authors.lastname: Tema
authors.affiliation: Giuseppe S Sica, Sara Di Carlo, Giorgia Tema, Giulia Maggi, Department of Surgery, Tor Vergata University Hospital, Rome 00133, Italy.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Montagnese
authors.affiliation: Giuseppe S Sica, Sara Di Carlo, Giorgia Tema, Giulia Maggi, Department of Surgery, Tor Vergata University Hospital, Rome 00133, Italy.
authors.forename: Giovanna
authors.initials: G
authors.lastname: Del Vecchio Blanco
authors.affiliation: Giuseppe S Sica, Sara Di Carlo, Giorgia Tema, Giulia Maggi, Department of Surgery, Tor Vergata University Hospital, Rome 00133, Italy.
authors.forename: Valeria
authors.initials: V
authors.lastname: Fiaschetti
authors.affiliation: Giuseppe S Sica, Sara Di Carlo, Giorgia Tema, Giulia Maggi, Department of Surgery, Tor Vergata University Hospital, Rome 00133, Italy.
authors.forename: Giulia
authors.initials: G
authors.lastname: Maggi
authors.affiliation: Giuseppe S Sica, Sara Di Carlo, Giorgia Tema, Giulia Maggi, Department of Surgery, Tor Vergata University Hospital, Rome 00133, Italy.
authors.forename: Livia
authors.initials: L
authors.lastname: Biancone
mesh_terms: D001003:Anal Canal / Q000187:drug effects / Q000503:physiopathology / Q000601:surgery*; D003424:Crohn Disease / Q000150:complications* / Q000175:diagnosis; D013505:Digestive System Surgical Procedures / Q000009:adverse effects; D005242:Fecal Incontinence / Q000209:etiology; D005765:Gastrointestinal Agents / Q000627:therapeutic use; D006801:Humans; D010348:Patient Care Team; D011237:Predictive Value of Tests; D012003:Rectal Fistula / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D012307:Risk Factors; D016896:Treatment Outcome; D014945:Wound Healing
chemical_list: D005765:Gastrointestinal Agents
keywords: Anal fistula treatment; Crohn’s disease; Fistula; Perianal fistula; Seton; Surgery; Surgical treatment