Surgical management of anorectal fistulas in Crohn's disease.

摘要: A retrospective review of patients with Crohn's disease treated at our institution from 1973 to 1986 revealed 35 operated upon for anorectal fistulas. Twenty-nine had low intermuscular fistulas (multiple in seven), and six high (supralevator) Fistulotomy alone was performed 19 patients, eight underwent partial fistulotomy seton insertion. Five additional proximal fecal diversion before fistulotomy. Three severe colonic proctocolectomy as the initial procedure. Of 32 who performed, complete healing occurred 30. Seven healed required more than one operation fistula. One patient left an asymptomatic fistula, proctectomy persistent symptomatic fistula proctitis. Success correlated absence rectal quiescent elsewhere gastrointestinal tract. Aggressive medical treatment is control bowel preoperatively. In majority subsequent surgery justified can be anticipated.