Abstract
There is a high reported incidence of persistent perineal sinus after proctectomy for inflammatory bowel disease. The cause and prevention are discussed. In a consecutive series, persistent perineal sinuses occurred in 4 of 17 patients with Crohn's colitis, and in none of 20 patients with ulcerative or unclassified colitis (1 died soon after operation). The technique is described for patients with a sinus persisting for more than 6 months, using total excision, primary closure, and suction drainage. Six of 7 patients so treated healed primarily and the seventh healed within 2 weeks. In males, sexual dysfunction was often decreased.
Résumé
Les amputations du rectum pour lésion inflammatoire laissent fréquemment comme séquelles des fistules périnéales. Leur cause et leur prévention sont discutées. Nous avons observé 4 fistules périnéales persistantes dans une série continue de 17 amputations rectales pour maladie de Crohn, mais aucune après proctectomie pour colite ulcéreuse ou colite non classifiée (1 décès post-opératoire). Nous décrivons une technique qui peut être utilisée en cas de fistule persistante après plus de 6 mois: elle comporte une exicision totale avec suture immédiate sur drainage en aspiration. Utilisée dans 7 cas, cette technique a donné 6 guérisons per primam et 1 cicatrisation après 2 semaines. De plus, les troubles sexuels sont, chez l'homme, fréquemment corrigés.
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Ferrari, B.T., DenBesten, L. The prevention and treatment of the persistent perineal sinus. World J. Surg. 4, 167–171 (1980). https://doi.org/10.1007/BF02393569
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DOI: https://doi.org/10.1007/BF02393569