Outcome of perianal fistulae in Crohn's disease--value of Hughes' pathogenic classification.

Applying the Hughes' pathogenic classification of ano-perineal lesions of Crohn's disease, this study was conducted to find out its possible prognostic value in perianal fistulas. Thirty-eight patients with ano-perianal fistulas were included; primary specific lesions (condyloma, cavitating ulcer, fissure) were found in 22 patients (group 1) and were absent in the other 16 patients (group 2). Patients of group 1 underwent more abdominal surgical interventions (G 1: 68%; G 2: 31% - P = 0.05), as well as proctological interventions (G 1: 2.95 operations/patient vs 1.35 in G 2 - P = 0.01). Perfect continence was recorded ultimately in 31.8% patients of G 1 compared to 62.5% of G 2. This study shows the very poor prognosis of ano-perianal fistulas in Crohn's disease.