Seminars in Colon & Rectal Surgery
Volume 17, Issue 2 , Pages 61-67 , June 2006

A Paradigm for the Management of Complex Perineal Crohn’s Disease in the Anti-TNF Era

  • Walter A. Koltun, MD

      Affiliations

    • Corresponding Author InformationAddress reprint requests to: Walter A. Koltun, MD, Professor of Surgery, Division Chief, Colon and Rectal Surgery, Penn State Milton S. Hershey Medical Center, 500 University Drive, MCH137, Hershey, PA 17033-0850.

References 

  1. Stringer EE , Nicholson TJ , Armstrong D . Efficacy of topical metronidazole (10 percent) in the treatment of anorectal Crohn’s disease . Dis Colon Rectum . 2005;48:970–974
  2. Cohen Z , McLeod RS . Perianal Crohn’s disease . Gastroenterol Clin North Am . 1987;16:175–189
  3. Williams JG , Rothenberger DA , Nemer FD , et al.   Fistula-in-ano in Crohn’s disease (Results of aggressive surgical treatment) . Dis Colon Rectum . 1991;34:378–384
  4. Nordgren S , Fasth S , Hulten L . Anal fistulas in Crohn’s disease: incidence and outcome of surgical treatment . Int J Colorectal Dis . 1992;7:214–218
  5. Bernstein LH , Frank MS , Brandt LJ , et al.   Healing of perineal Crohn’s disease with metronidazole . Gastroenterology . 1980;79:357–365
  6. Greenberg GR . Antibiotics should be used as first-line therapy for Crohn’s disease . Inflamm Bowel Dis . 2004;10:318–320
  7. Present DH , Korelitz BI , Wisch N , et al.   Treatment of Crohn’s disease with 6-mercaptopurine (A long-term, randomized, double-blind study) . N Engl J Med . 1980;302:981–987
  8. Korelitz BI . Immunosuppressive therapy of inflammatory bowel disease: a historical perspective . Gastroenterologist . 1995;3:141–152
  9. Sandborn W . A critical review of cyclosporine therapy in inflammatory bowel disease . Inflamm Bowel Dis . 1995;1:48–63
  10. Lowry PW , Weaver AL , Tremaine WJ , et al.   Combination therapy with oral tacrolimus (FK506) and azathioprine or 6-mercaptopurine for treatment-refractory Crohn’s disease perianal fistulae . Inflamm Bowel Dis . 1999;5:239–245
  11. Present DH , Rutgeerts P , Targan S , et al.   Infliximab for the treatment of fistulas in patients with Crohn’s disease . N Engl J Med . 1999;340:1398–1405
  12. Sands BE , Anderson FH , Bernstein CN , et al.   Infliximab maintenance therapy for fistulizing Crohn’s disease . N Engl J Med . 2004;350:934–936
  13. Blonski W , Lichtenstein GR . Complications of biological therapy for inflammatory bowel diseases . Curr Opin Gastroenterol . 2006;22:30–43
  14. Bickston SJ , Lichtenstein GR , Arseneau KO , et al.   The relationship between infliximab treatment and lymphoma in Crohn’s disease . Gastroenterology . 1999;117:1433–1437
  15. Hanauer SB , Wagner CL , Bala M , et al.   Incidence and importance of antibody responses to infliximab after maintenance or episodic treatment in Crohn’s disease . Clin Gastroenterol Hepatol . 2004;2:542–553
  16. Arseneau KO , Cohn SM , Cominelli F , et al.   Cost-utility of initial medical management for Crohn’s disease perianal fistulae . Gastroenterology . 2001;120:1640–1656
  17. Lichtenstein GR , Songkai Y , Bala M , et al.   Infliximab maintenance treatment reduces hospitalizations, surgeries, and procedures in fistulizing Crohn’s disease . Gastroenterology . 2005;128:862–869
  18. Poritz LS , Rowe W , Koltun WA . Remicade does not abolish the need for surgery in fistulizing Crohn’s disease . Dis Colon Rectum . 2002;45:771–775
  19. Rutgeerts P , Feagan BG , Lichtenstein GR , et al.   Comparison of scheduled and episodic treatment strategies of infliximab in Crohn’s disease . Gastroenterology . 2004;126:402–413
  20. Van Assche G , Vanbeckevoort D , Bielen D , et al.   Magnetic resonance imaging of the effects of infliximab on perianal fistulizing Crohn’s disease . Am J Gastroenterol . 2003;98:332–339
  21. Ardizzone S , Maconi G , Colombo E , et al.   Perianal fistulae following infliximab treatment: clinical and endosonographic outcome . Inflamm Bowel Dis . 2004;10:91–96
  22. Rasul I , Wilson SR , MacRae H , et al.   Clinical and radiological responses after infliximab treatment for perianal fistulizing Crohn’s disease . Am J Gastroenterol . 2004;99:89–90
  23. Parsi MA , Lashner BA , Achkar JP , et al.   Type of fistula determines response to infliximab in patients with fistulous Crohn’s disease . Am J Gastroenterol . 2004;99:445–449
  24. Sabate JM , Villarejo J , Lemann M , et al.   An open-label study of thalidomide for maintenance therapy in responders to infliximab in chronically active and fistulizing refractory Crohn’s disease . Aliment Pharmacol Ther . 2002;16:1117–1124
  25. West RL , van der Woude CJ , Hansen BE , et al.   Clinical and endosonographic effect of ciprofloxacin on the treatment of perianal fistulae in Crohn’s disease with infliximab: a double-blind placebo-controlled study . Aliment Pharmacol Ther . 2004;20:1329–1336
  26. Regueiro M , Mardini H . Treatment of perianal fistulizing Crohn’s disease with infliximab alone or as an adjunct to exam under anesthesia with seton placement . Inflamm Bowel Dis . 2003;9:98–103
  27. van der Hagen SJ , Baeten CG , Soeters PB , et al.   Anti-TNF-alpha (infliximab) used as induction treatment in case of active proctitis in a multistep strategy followed by definitive surgery of complex anal fistulas in Crohn’s disease: a preliminary report . Dis Colon Rectum . 2005;48:758–767
  28. Pritchard TJ , Schoetz DJ , Roberts PL , et al.   Perirectal abscess in Crohn’s disease (Drainage and outcome) . Dis Colon Rectum . 1990;33:933–937
  29. White RA , Eisenstat TE , Rubin RJ , et al.   Seton management of complex anorectal fistulas in patients with Crohn’s disease . Dis Colon Rectum . 1990;33:587–589
  30. Faucheron JL , Saint-Marc O , Guibert L , et al.   Long-term seton drainage for high anal fistulas in Crohn’s disease—a sphincter-saving operation? . Dis Colon Rectum . 1996;39:208–211
  31. Sangwan YP , Schoetz DJ , Murray JJ , et al.   Perianal Crohn’s disease (Results of local surgical treatment) . Dis Colon Rectum . 1996;39:529–535
  32. Makowiec F , Jehle EC , Becker HD , et al.   Perianal abscess in Crohn’s disease . Dis Colon Rectum . 1997;40:443–450
  33. Talbot C , Sagar PM , Johnston MJ , et al.   Infliximab in the surgical management of complex fistulating anal Crohn’s disease . Colorectal Dis . 2005;7:164–168
  34. Topstad DR , Panaccione R , Heine JA , et al.   Combined seton placement, infliximab infusion, and maintenance immunosuppressives improve healing rate in fistulizing anorectal Crohn’s disease: a single center experience . Dis Colon Rectum . 2003;46:577–583
  35. Yamamoto T , Allan RN , Keighley MR . Effect of fecal diversion alone on perianal Crohn’s disease . World J Surg . 2000;24:1258–1262
  36. Guillem JG , Roberts PI , Murray JJ , et al.   Factors predictive of persistent or recurrent Crohn’s disease in excluded rectal segments . Dis Colon Rectum . 1992;35:768–772
  37. Makowiec F , Jehle EC , Becker HD , et al.   Clinical course after transanal advancement flap repair of perianal fistula in patients with Crohn’s disease . Br J Surg . 1995;82:603–606
  38. Jones IT , Fazio VW , Jagelman DG . The use of transanal rectal advancement flaps in the management of fistulas involving the anorectum . Dis Colon Rectum . 1987;30:919–923
  39. Hull TL , Fazio VW . Surgical approaches to low anovaginal fistula in Crohn’s disease . Am J Surg . 1997;173:95–98
  40. Joo JS , Weiss EG , Nogueras JJ , et al.   Endorectal advancement flap in perianal Crohn’s disease . Am Surg . 1998;64:147–150
  41. Marchesa P , Hull TL , Fazio VW . Advancement sleeve slaps for treatment of severe perianal Crohn’s disease . Br J Surg . 1998;85:1695–1698
  42. Penninckx F , Moneghini D , D’Hoore A , et al.   Success and failure after repair of rectovaginal fistula in Crohn’s disease: analysis of prognostic factors . Colorectal Dis . 2001;3:406–411
  43. Vitton V , Gasmi M , Barthet M , et al.   Long-term healing of Crohn’s anal fistulas with fibrin glue injection . Aliment Pharmacol Ther . 2005;21:1453–1457
  44. Loungnarath R , Dietz DW , Mutch MG , et al.   Fibrin glue treatment of complex anal fistulas has low success rate . Dis Colon Rectum . 2004;47:432–436
  45. Johnson EK , Gaw JU , Armstrong DN . Efficacy of anal fistula plug vs. fibrin glue in closure of anorectal fistulas . Dis Colon Rectum . 2006;49:371–376

PII: S1043-1489(06)00060-1

doi: 10.1053/j.scrs.2006.06.006

Seminars in Colon & Rectal Surgery
Volume 17, Issue 2 , Pages 61-67 , June 2006