Fistula treatment: the unresolved challenge.

Details

Serval ID
serval:BIB_1264B1068B09
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Institution
Title
Fistula treatment: the unresolved challenge.
Journal
Digestive Diseases
Author(s)
Michetti Pierre
ISSN
1421-9875[electronic]
Publication state
Published
Issued date
2009
Peer-reviewed
Oui
Volume
27
Number
3
Pages
387-393
Language
english
Notes
Publication types: Journal Article ; Review Publication
Abstract
Fistulas are common complications in Crohn's disease, as their cumulative prevalence reaches up to two thirds of the patients in the long term. Fistulas worsen the overall patient prognosis, with permanent sphincter and perineal tissue destruction as well as professional and personal disabilities. The importance of healing these fistulas has been less well appreciated than mucosal healing for luminal disease. Management should not be left to any specialty alone, but requires an optimal combination of surgery, infection control, and immunosuppression. Outcome of therapy beyond fistula drainage is unclear and the means of assessing healing over a long time period is poorly characterized. Recent studies suggested that a substantial proportion of patients can achieve fistula healing with surgical and medical therapies. However, studies that measure the benefit of integrated approaches, of early intervention and of precise healing assessment are still missing. Such information is particularly needed in this subset of sick patients that undergo substantial physical and emotional distress because of pain, discharge, incontinence, perineal and genital disfigurement. The advent of adequate pelvic imaging, improved surgical outcomes, and potent biological therapies make it timely to develop best-management strategies and appropriateness of care criteria.
Keywords
Crohn Disease/complications, Fistula/complications, Fistula/diagnosis, Humans
Pubmed
Web of science
Create date
14/01/2010 13:38
Last modification date
20/08/2019 12:40
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