Fistula treatment: the unresolved challenge.

Détails

ID Serval
serval:BIB_1264B1068B09
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Synthèse (review): revue aussi complète que possible des connaissances sur un sujet, rédigée à partir de l'analyse exhaustive des travaux publiés.
Collection
Publications
Institution
Titre
Fistula treatment: the unresolved challenge.
Périodique
Digestive Diseases
Auteur(s)
Michetti Pierre
ISSN
1421-9875[electronic]
Statut éditorial
Publié
Date de publication
2009
Peer-reviewed
Oui
Volume
27
Numéro
3
Pages
387-393
Langue
anglais
Notes
Publication types: Journal Article ; Review Publication
Résumé
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.
Mots-clé
Crohn Disease/complications, Fistula/complications, Fistula/diagnosis, Humans
Pubmed
Web of science
Création de la notice
14/01/2010 13:38
Dernière modification de la notice
20/08/2019 12:40
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