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摘要:
BACKGROUND Perianal fistulae strongly impact on quality of life of affected patients.AIM To challenge and novel minimally invasive treatment options are needed.METHODS Patients with Crohn’s disease(CD)in remission and patients without inflammatory bowel disease(non-IBD patients)were treated with fistulodesis,a method including curettage of fistula tract,flushing with acetylcysteine and doxycycline,Z-suture of the inner fistula opening,fibrin glue instillation,and Zsuture of the outer fistula opening followed by post-operative antibiotic prophylaxis with ciprofloxacin and metronidazole for two weeks.Patients with a maximum of 2 fistula openings and no clinical or endosonographic signs of a complicated fistula were included.The primary end point was fistula healing,defined as macroscopic and clinical fistula closure and lack of patient reported fistula symptoms at 24 wk.RESULTS Fistulodesis was performed in 17 non-IBD and 3 CD patients,with a total of 22 fistulae.After 24 wk,all fistulae were healed in 4 non-IBD and 2 CD patients(overall 30%)and fistula remained closed until the end of follow-up at 10-25 mo.In a secondary per-fistula analysis,7 out of 22 fistulae(32%)were closed.Perianal disease activity index(PDAI)improved in patients with fistula healing.Low PDAI was associated with favorable outcome(P=0.0013).No serious adverse events were observed.CONCLUSION Fistulodesis is feasible and safe for perianal fistula closure.Overall success rates is at 30%comparable to other similar techniques.A trend for better outcomes in patients with low PDAI needs to be confirmed.
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篇名 Perianal fistulodesis–A pilot study of a novel minimally invasive surgical and medical approach for closure of perianal fistulae
来源期刊 世界胃肠外科杂志:英文版(电子版) 学科 医学
关键词 FISTULA Fibrin glue Crohn's disease Perianal disease activity index Inflammatory bowel disease Fistula closure
年,卷(期) 2021,(2) 所属期刊栏目
研究方向 页码范围 187-197
页数 11页 分类号 R57
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FISTULA
Fibrin
glue
Crohn's
disease
Perianal
disease
activity
index
Inflammatory
bowel
disease
Fistula
closure
研究起点
研究来源
研究分支
研究去脉
引文网络交叉学科
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期刊影响力
世界胃肠外科杂志:英文版(电子版)
月刊
1948-9366
北京市朝阳区东四环中路62号楼远洋国际中
出版文献量(篇)
75
总下载数(次)
0
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0
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