Emerging treatments for complex perianal fistula in Crohn's disease

查看全文 作　　者：Carlos [1]Taxonera;David A [2]Schwartz;Damián García-[3]Olmo

机构地区：[1]Inflammatory Bowel Disease Unit,Department of Gastroenterology,Hospital Clínico;[2]Inflammatory Bowel Disease Center,Vanderbilt University Medical Center;[3]Department of General Surgery,'La Paz'University Hospital

出　　处：《World Journal of Gastroenterology》索引2009年第15卷第34期,共10页

摘　　要：Complex perianal fistulas have a negative impact on the quality of life of sufferers and should be treated.Correct diagnosis,characterization and classification of the fistulas are essential to optimize treatment.Nevertheless, in the case of patients whose fistulas are associated with Crohn's disease,complete closure is particularly difficult to achieve.Systemic medical treatments(antibiotics, thiopurines and other immunomodulatory agents,and, more recently,anti-tumor necrosis factor-αagents such as infliximab)have been tried with varying degrees of success.Combined medical(including infliximab)and less aggressive surgical therapy(drainage and seton placement)offer the best outcomes in complex Crohn's fistulas while more aggressive surgical procedures such as fistulotomy or fistulectomy may increase the risk of incontinence.This review will focus on emerging novel treatments for perianal disease in Crohn's patients. These include locally applied infliximab or tacrolimus, fistula plugs,instillation of fibrin glue and the use of adult expanded adipose-derived stem cell injection.More welldesigned controlled studies are required to confirm the effectiveness of these emerging treatments. 关键词：手术治疗肿瘤坏死因子免疫调节剂纤维蛋白胶质量产生优化处理外科手术脂肪来源

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Emerging treatments for complex perianal fistula in Crohn's disease

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