Long-Term Outcome of Surgery for Perianal Crohn’s Fistula
Abstract
:1. Introduction
2. Materials and Methods
Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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First Surgery | n | Male | Median Age (Range) at First Surgery | Only Perineal Location of Crohn | Perineal and Other Location |
---|---|---|---|---|---|
Seton drainage only | 108 (29.6%) | 63 (58.3%) | 31.5 (13.4–74.0) | 36 (33.3%) | 72 (66.7%) |
Fistulectomy ± Mucosal sliding flap | 216 (59.2%) | 108 (50%) | 31.9 (4–80) | 52 (24.1%) | 162 (75%) |
Seton drainage + Fistulectomy/Mucosal sliding flap | 32 (8.8%) | 20 (62.5%) | 30.9 (14–51.7) | 10 (31.25%) | 22 (68.75%) |
Fistula plug or fibrin glue instillation | 9 (2.5%) | 6 (66.7%) | 50.4 (19.3–64) | 1 (11.1%) | 8 (88.9%) |
Total | 365 (100%) | 197 (54%) | 31.9 (4–80) | 99 (27.1%) | 264 (72.3%) |
First Surgery | Patients with a Healed Fistula at Last Available Follow-Up | Median Follow-Up (Range), in Years | No Additional Surgery | One Additional Surgery | 2 or More Additional Surgery | ||
---|---|---|---|---|---|---|---|
n | n | Median Time to (yrs, Range) | n | Median Time to (yrs, Range) | |||
Seton drainage | 65/108 (60%) | 8.3 (1–27) | 34 (52%) | 23 (35%) | 5.9 (2.5–18) | 8 (12%) | 7.8 (4–10) |
Fistulectomy ± Mucosal sliding flap | 162/216 (75%) | 7.4 (0.5–4) | 111 (69%) | 41 (25%) | 13.8 (0.8–42) | 10 (6%) | 13.3 (6–26) |
Seton drainage + Fistulectomy/ Mucosal sliding flap | 23/32 (72%) | 7.3 (2–18) | 15 (65%) | 6 (26%) | 6.9 (3–10) | 2 (9%) | 7.3 (4–11) |
Fistula plug or fibrin glue instillation | 5/9 (55%) | 2.8 (2–3) | 4 (80%) | 1 (20%) | 6 | 0 (0%) | - |
Healed Fistula (n = 104) | Unhealed Fistula (n = 61) | p-Value | |
---|---|---|---|
Median follow-up (range), in years | 8.1 (0.4–27.2) | 5.8 (0.2–34.2) | 0.10 |
Age at Seton drainage (median, range) | 31.8 (13.4–74.0) | 31.7 (14.7–58.7) | 0.56 |
Male gender | 62 (59.6%) | 35 (57.4%) | 0.78 |
Only perineal location of Crohn | 36 (34.6%) | 20 (32.8%) | 0.81 |
Percentage smoker | 22/93 (23.7%) | 17/59 (28.8%) | 0.48 |
Current Crohn Disease Activity Index (median, range) | 6 (0–182) | 33 (0–217) | 0.0001 |
Current Anti-TNF medication | 50 (48.1%) | 35 (57.4%) | 0.25 |
Additional surgery (any) | 46 (44.2%) | 36 (59.0%) | 0.45 |
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Schaad, M.; Schoepfer, A.; Rossel, J.-B.; Barry, M.P.; Rogler, G.; Hahnloser, D., on behalf of the Swiss IBD Cohort Study Group. Long-Term Outcome of Surgery for Perianal Crohn’s Fistula. Medicina 2024, 60, 1035. https://doi.org/10.3390/medicina60071035
Schaad M, Schoepfer A, Rossel J-B, Barry MP, Rogler G, Hahnloser D on behalf of the Swiss IBD Cohort Study Group. Long-Term Outcome of Surgery for Perianal Crohn’s Fistula. Medicina. 2024; 60(7):1035. https://doi.org/10.3390/medicina60071035
Chicago/Turabian StyleSchaad, Marie, Alain Schoepfer, Jean-Benoît Rossel, Mamadou Pathé Barry, Gerhard Rogler, and Dieter Hahnloser on behalf of the Swiss IBD Cohort Study Group. 2024. "Long-Term Outcome of Surgery for Perianal Crohn’s Fistula" Medicina 60, no. 7: 1035. https://doi.org/10.3390/medicina60071035