Winter A M, Banks P A, Petros J G
Department of Medicine, St. Elizabeth's Hospital, Boston, Massachusetts.
Am J Gastroenterol. 1993 Dec;88(12):2022-5.
Transsphincteric perianal fistulas in Crohn's disease are often refractory to medical therapy and difficult to treat surgically. Our objective was to determine whether a new method of anal fistulotomy was effective in healing these fistulas.
In this new method, the internal opening of the fistula tract was displaced distally to the region of the anal mucosa in 26 patients with Crohn's disease.
Healing was achieved within 5 weeks of surgery in 45/49 (92%) of the fistulas and was not influenced by perioperative medication, site of preexisting Crohn's disease, or condition of the rectum. There has been no alteration of preoperative continence.
We conclude that this method is highly effective in treating transsphincteric perianal fistulas in Crohn's disease.
克罗恩病中的经括约肌肛周瘘通常对药物治疗无效且手术治疗困难。我们的目的是确定一种新的肛瘘切开术方法治疗这些瘘管是否有效。
在这种新方法中，对26例克罗恩病患者，将瘘管的内口向远侧移位至肛门黏膜区域。
49个瘘管中有45个（92%）在术后5周内愈合，且不受围手术期用药、原有克罗恩病的部位或直肠状况的影响。术前的控便能力未发生改变。
我们得出结论，该方法治疗克罗恩病中的经括约肌肛周瘘非常有效。
