| Popis: |
Background According to the etiological classification, anal fistulas in Crohn’s disease (CD) which derived from CD lesions are secondary lesions (s.l.). We classified s.l. as follows: In case of presence of clear CD lesion at the primary orifice (p.o.), it was classified as s.l.CD lesion (+), whereas in the absence of CD lesion, it was classified as a s.l.CD lesion (-). To examine the prognosis of patients that primary orifice (p.o.) is not on the dentate line and no clear CD lesion. Methods 17 patients who have been followed up for >5 years post-the first examination under anesthesia (EUA) were included in the study. To determine the therapeutic effect, we defined cases with closed fistula as cured, those in whom drain can be removed, but symptoms may exist as improved, those in whom drains cannot be removed as unchanged, and those in whom rectal amputation was required as worsened. The target cases were divided into s.l.CD lesion (+), and s.l.CD lesion (-), and the prognosis was examined. Results Nine and eight patients showed s.l.CD lesion (+), and s.l.CD lesion (-), respectively. The results are shown in the table 1. Among s.l. cases, more patients with CD lesion (-) underwent biotreatment before EUA than those with s.l.CD lesion (+); furthermore, biotreatment was started earlier after EUA in the former than in the latter. Nevertheless, the prognosis of CD lesion (-) cases tended to be poor. Conclusions Based on the findings, the prognosis of patients that p.o. is not on the dentate line and no clear CD lesion is poor. |
