Clinical Outcome of a Rectovaginal Fistula in Crohn's Disease
Journal of the Korean Society of Coloproctology
;
: 10-15, 2007.
Artigo
em Inglês
| WPRIM
| ID: wpr-35210
ABSTRACT
PURPOSE:
The aim of this study is to analyze the outcome of a variety of treatments, including local surgical treatments, diverting stoma, and combined medical therapy, for patients with a rectovaginal fistula complicating Crohn's disease.METHODS:
Between 1994 and 2003, twenty-one patients with a rectovaginal fistula complicating Crohn's disease from a prospectively compiled 422-patient Crohn's disease database were reviewed.RESULTS:
All three patients treated by seton and fibrin glue recurred despite having relatively long tracts. Of six patients with infliximab treatment combined with a seton procedure, five patients had an improvement of their symptoms, but were not cured. Of eight patients with a transanal or endovaginal advancement flap techniques, three had successful closure, three eventually required a proctectomy, and two had a recurrent fistula without symptoms. Four (2 without any local treatments, and 2 with seton placement) of 16 patients who had a diverting stoma during treatment had successful closure. All proctectomy patients (n=8) had rectal involvement of Crohn's disease. Two patients who underwent a proctectomy with a presumptive diagnosis of ulcerative colitis and indeterminate colitis turned out to have Crohn's disease. Overall, except for the proctectomy patients, seven patients (54%) had successful closure, but six (four without symptoms, and two with symptoms) following a wide spectrum of treatments had recurrence after a mean follow-up of 44 months.CONCLUSIONS:
Combining different treatments for a rectovaginal fistula in Crohn's disease can be successful in a reasonable number of cases. The presence of uncontrolled perianal sepsis and/or complicated anorectal problems is likely to lead to a proctectomy.
Texto completo:
DisponíveL
Índice:
WPRIM (Pacífico Ocidental)
Assunto principal:
Recidiva
/
Colite Ulcerativa
/
Doença de Crohn
/
Adesivo Tecidual de Fibrina
/
Seguimentos
/
Fístula Retovaginal
/
Colite
/
Sepse
/
Diagnóstico
/
Fístula
Tipo de estudo:
Estudo diagnóstico
/
Estudo observacional
/
Estudo prognóstico
Limite:
Humanos
Idioma:
Inglês
Revista:
Journal of the Korean Society of Coloproctology
Ano de publicação:
2007
Tipo de documento:
Artigo
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