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Surgical vs Medical Management of Symptomatic Anal Fistulas in Patients with Crohn’s Disease

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Difficult Decisions in Colorectal Surgery

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Abstract

One of the most common presentations of Crohn’s Disease (CD) is the formation of perianal fistulas which affects anywhere from 5–40% of CD patients worldwide, and it can be the initial presenting phenotype in 10% of CD patients. Perianal fistulizing disease is quite heterogeneous in its presentation, and complete remission is notoriously challenging to achieve. As such, a multidisciplinary medical and surgical approach is required in order to maximize optimal patient outcomes.

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Conflict of Interest

Amy Lightner: consultant for Takeda, Mesoblast, Ossium, Boomerang, Direct Biologics

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  1. Department of General Surgery, Digestive Disease Surgical Institute, Cleveland Clinic, Cleveland, OH, USA

    Megan Obi

  2. Department of Colorectal Surgery, Digestive Disease Surgical Institute, Cleveland Clinic, Cleveland, OH, USA

    Amy L. Lightner

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  1. Medical Center, University of Chicago, Chicago, IL, USA

    Konstantin Umanskiy

  2. Medical Center, University of Chicago, Chicago, IL, USA

    Neil Hyman

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Obi, M., Lightner, A.L. (2023). Surgical vs Medical Management of Symptomatic Anal Fistulas in Patients with Crohn’s Disease. In: Umanskiy, K., Hyman, N. (eds) Difficult Decisions in Colorectal Surgery. Difficult Decisions in Surgery: An Evidence-Based Approach. Springer, Cham. https://doi.org/10.1007/978-3-031-42303-1_2

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