克罗恩病肛周瘘管的管理
Management of Perianal Fistulas in Crohn's Disease.
作者信息
Seyfried Steffen, Herold Alexander
机构信息
Department of Surgery, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
Deutsches End- und Dickdarmzentrum, Mannheim, Germany.
出版信息
Visc Med. 2019 Dec;35(6):338-343. doi: 10.1159/000504103. Epub 2019 Nov 12.
Abstract
BACKGROUND
Perianal fistulizing Crohn's disease is associated with severe symptoms such as pain, fecal incontinence, and a significant reduction in quality of life.
RESULTS
In refractory cases, many patients face the decision of having a stoma and/or requiring proctectomy. In former years, the standard of care was a complete fistulectomy, bringing with it a high rate of continence disorders. Additionally, many patients received indefinite treatment, namely the placement of a seton to maintain surgical drainage.
CONCLUSION
More recently, newer biologics, cell-based therapies as well as novel surgical techniques have been introduced, raising new hopes that outcomes can be improved upon.
摘要
背景
肛周瘘管性克罗恩病与疼痛、大便失禁等严重症状相关，会导致生活质量显著下降。
结果
在难治性病例中，许多患者面临造口和/或需要直肠切除术的抉择。前些年，标准治疗方法是完全瘘管切除术，这带来了较高的大便失禁发生率。此外，许多患者接受了长期治疗，即放置挂线以维持手术引流。
结论
最近，新型生物制剂、基于细胞的疗法以及新颖的手术技术已经出现，带来了改善治疗效果的新希望。
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