Funayama Y, Sasaki I, Imamura M, Naito H, Kamiyama Y, Sato T
Nihon Geka Gakkai Zasshi. 1987 May;88(5):562-8.
Perianal lesions associated with Crohn's disease are often intractable and require surgical intervention. Among 28 patients surgically treated in our department, 16 patients manifested perianal complications consisted of four periproctal abscesses, eight anal fistulas, three skin tags and one anal fissure. The incidence of perianal lesions was higher in ileocolic type than in colic and ileal type. In half of our patients perianal lesions preceded the diagnosis of Crohn's disease, and they often gave the important clue for the diagnosis. The perianal lesions seemed to be independent of the activity of the intestinal lesions. The surgical treatments for the perianal lesions were performed on 13 patients and the results were satisfactory in most cases. But the results were very poor in four patients with rectal involvement. Two of them were obliged to undergo proctectomy because of the severely diseased anorectal lesions. Therefore radical surgery should be considered in patients whose perianal lesions are quiescent, and the severity of the rectal lesion was considered to be the major factor which decides the prognosis of the patients.
与克罗恩病相关的肛周病变通常难以处理，需要手术干预。在我科接受手术治疗的28例患者中，16例出现肛周并发症，包括4例直肠周围脓肿、8例肛瘘、3例皮赘和1例肛裂。回结肠型患者的肛周病变发生率高于结肠型和回肠型。我们一半的患者肛周病变先于克罗恩病的诊断出现，它们常常为诊断提供重要线索。肛周病变似乎与肠道病变的活动无关。13例患者接受了肛周病变的手术治疗，多数病例结果满意。但4例直肠受累患者的手术效果很差。其中2例因严重的肛肠病变不得不接受直肠切除术。因此，对于肛周病变静止的患者应考虑行根治性手术，直肠病变的严重程度被认为是决定患者预后的主要因素。
