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World J Gastroenterol. Oct 7, 2014; 20(37): 13205-13210
Published online Oct 7, 2014. doi: 10.3748/wjg.v20.i37.13205
Published online Oct 7, 2014. doi: 10.3748/wjg.v20.i37.13205
Treatment of peri-anal fistula in Crohn's disease
Giuseppe S Sica, Sara Di Carlo, Giorgia Tema, Giulia Maggi, Department of Surgery, Tor Vergata University Hospital, Rome 00133, Italy
Fabrizio Montagnese, San Giuseppe Hospital, Albano Laziale, Rome 00041, Italy
Giovanna Del Vecchio Blanco, Livia Biancone, Department of Medicine, Tor Vergata University Hospital, Rome 00133, Italy
Valeria Fiaschetti, Department of Radiology, Tor Vergata University Hospital, Rome 00133, Italy
Author contributions: Sica GS, Di Carlo S, Tema G and Montagnese F contributed equally to this work; Sica GS and Biancone L designed research; Sica GS and Di Carlo S wrote the paper; Del Vecchio Blanco G and Fiaschetti V provided field of expertise; Tema G and Maggi G performed data analysis and bibliographic research; Biancone L critically revised the manuscript.
Correspondence to: Giuseppe S Sica, Professor, Department of Surgery, Tor Vergata University Hospital, 81 Viale Oxford, Rome 00133, Italy. sigisica@gmail.com
Telephone: +39-6-20903596 Fax: +39-6-20902927
Received: February 11, 2014
Revised: June 3, 2014
Accepted: July 11, 2014
Published online: October 7, 2014
Revised: June 3, 2014
Accepted: July 11, 2014
Published online: October 7, 2014
Core Tip
Core tip: Treatment of anal fistulas in Crohn’s disease is a challenging clinical problem. Although several studies have been published, a consensus on treatment strategy has not yet been achieved. Clinical experience suggests that treatment should be determined according to the type and clinical behavior of the fistula. Asymptomatic fistulas should not be treated, while symptomatic ones could benefit from combined medical and surgical treatment. Surgery can vary from simple drainage and setonage, to more complex and sophisticated procedures. The overall aim of the surgical procedures is fistula healing without compromising fecal continence.