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Does Infliximab Infusion Impact Results of Operative Treatment for Crohn’s Perianal Fistulas?

  • Original Contributions
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Diseases of the Colon & Rectum

Abstract

Purpose

Infliximab is an effective treatment for active intestinal Crohn’s disease; however, the efficacy of infliximab in perianal Crohn’s disease is controversial. This study was designed to compare patients with Crohn’s disease who underwent perianal fistula surgery with or without infliximab infusion.

Methods

A retrospective chart review of 226 consecutive patients with Crohn’s disease who underwent operative treatment with or without infliximab (3- infusions of 5 mg/kg) from March 1991 through December 2005 was completed. Patients were classified as completely healed, minimally symptomatic (seton placement with minimal drainage and/or infliximab dependence), and failure (persistent or recurrent symptomatic fistula, diverting procedure, or proctectomy).

Results

A total of 226 patients underwent operative treatment alone (n--47) or in combination with infliximab infusion (n--9). Age, gender, and preoperative history of intestinal and perianal Crohn’s disease were similar between groups. Mean follow-up was 30 (range, 6-16) months. Operative treatment consisted of seton drainage (n--12), conventional fistulotomy (n--2), fibrin glue injection (n--4), advancement flap (n--), collagen plug insertion (n--), and transperineal repair (n--). Eighty-eight patients (60 percent) healed completely with operative treatment alone, and 47 patients (59 percent) healed after operative treatment in combination with infliximab (P- not significant).

Conclusions

Operative treatment of perianal fistulas in patients with Crohn’s disease resulted in complete healing in approximately 60 percent of patients. Preoperative infliximab infusion did not affect overall healing rates.

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Author information

Authors and Affiliations

  1. Division of Colon and Rectal Surgery, Department of Surgery, University of Minnesota, 420 Delaware Street SE, MMC 195, Minneapolis, MN, 55455, USA

    Wolfgang B. Gaertner M.D., Alejandra Decanini M.D., Anders Mellgren M.D., Ph.D., Ann C. Lowry M.D., Stanley M. Goldberg M.D., Robert D. Madoff M.D. & Michael P. Spencer M.D.

Authors
  1. Wolfgang B. Gaertner M.D.
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  2. Alejandra Decanini M.D.
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  3. Anders Mellgren M.D., Ph.D.
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  4. Ann C. Lowry M.D.
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  5. Stanley M. Goldberg M.D.
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  6. Robert D. Madoff M.D.
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  7. Michael P. Spencer M.D.
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Correspondence to Wolfgang B. Gaertner M.D..

Additional information

Read at the meeting of The American Society of Colon and Rectal Surgeons, St. Louis, Missouri, June 2 to 6, 2007.

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Gaertner, W.B., Decanini, A., Mellgren, A. et al. Does Infliximab Infusion Impact Results of Operative Treatment for Crohn’s Perianal Fistulas?. Dis Colon Rectum 50, 1754–1760 (2007). https://doi.org/10.1007/s10350-007-9077-3

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  • DOI: https://doi.org/10.1007/s10350-007-9077-3

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