Buchmann P, Keighley M R, Allan R N, Thompson H, Alexander-Williams J
Am J Surg. 1980 Nov;140(5):642-4. doi: 10.1016/0002-9610(80)90048-3.
A 10 year follow-up of 109 patients with histologic Crohn's disease and anal lesions is reported. Fourteen patients (13 percent) have died, 7 from unrelated disorders. Ten required excision of the rectum, but only 5 for perianal disease (4.5 percent). Of the remaining 85 patients, 61 have been followed up to proctoscopy and rectal biopsy. Anal skin tags were still evident in 25 of 37 patients (68 percent), but new tags have appeared in only 2 patients. Ten of 53 fissures (19 percent) were still present at 10 years, and there were no new fissures. Seven of 21 patients (33 percent) still had fistulas but were asymptomatic; the remainder of the fistulas had healed spontaneously (8) or after operation (6). New fistulas have appeared in five patients. None of the patients have been in continent. These results indicate that perianal manifestations of Crohn's disease pursue a relatively benign course and are rarely an indication for proctectomy.
报告了109例组织学确诊的克罗恩病伴肛门病变患者的10年随访情况。14例患者（13%）死亡，7例死于无关疾病。10例患者需要切除直肠，但仅5例因肛周疾病（4.5%）。其余85例患者中，61例接受了直肠镜检查和直肠活检随访。37例患者中有25例（68%）肛门皮赘仍明显，但仅2例出现新皮赘。53例肛裂患者中有10例（19%）在10年后仍存在，且无新肛裂出现。21例患者中有7例（33%）仍有肛瘘但无症状；其余肛瘘已自发愈合（8例）或手术后愈合（6例）。5例患者出现了新肛瘘。所有患者均有大便失禁。这些结果表明，克罗恩病的肛周表现病程相对良性，很少需要行直肠切除术。
