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A new protocolised treatment strategy optimising medical and surgical care leads to improved healing of Crohn's perianal fistulas.
J Crohns Colitis
January 2025
St Vincent's Hospital Melbourne, Department of Gastroenterology.
Background & Aims: Crohn's perianal fistula healing rates remain low. We evaluated the efficacy of a protocolised multidisciplinary treatment strategy optimising care in adults with Crohn's perianal fistulas.
Methods: A new treatment strategy was established at a single tertiary centre.
Clinical Course of Isolated Recurrent, Persistent Complex Perianal Fistulas Without Luminal Crohn's Disease: A Multicenter Case Series of 24 Patients.
Crohns Colitis 360
October 2024
Gastroenterology Associates Inc. (Powered by GI Alliance), The Warren Alpert Medical School of Brown University, Providence, RI, USA.
Background: Isolated complex perianal fistulas, without luminal evidence of inflammatory bowel disease in the gastrointestinal tract, pose diagnostic and treatment dilemmas for gastroenterologists and colorectal surgeons. For patients who develop recurrent complex fistulas, a presumptive diagnosis of Crohn's disease may be made. It is unclear whether these cases of isolated perianal disease in the absence of luminal inflammation truly represent isolated severe cryptoglandular fistulas or rather an early presentation of Crohn's disease.
View Article and Find Full Text PDFAutologous Microfragmented Adipose Tissue Injection in Refractory Complex Crohn's Perianal Fistulas: Long-Term Results at 6.7 Years Mean Follow-up.
Inflamm Bowel Dis
December 2024
Department of Medical and Surgical Sciences, Surgery of the Alimentary Tract, IRCCS S. Orsola-Malpighi Hospital, DIMEC, University of Bologna, Bologna, Italy.
Background: Nowadays, there is a clear need for new viable therapeutic options to face complex perianal Crohn's disease (PCD). Results of our previous pilot study demonstrated the efficacy and safety of local injection of autologous microfragmented adipose tissue (MFat) in this setting. This study aims to evaluate the long-term follow-up results in the same cohort of patients.
View Article and Find Full Text PDFIn Situ Treatment of Refractory Perianal Fistulas in Dogs with Low-Dose Allogeneic Adipose-Derived Mesenchymal Stem Cells.
Animals (Basel)
November 2024
Grupo Medicina Regenerativa, Universidad Científica del Sur, Lima 150142, Peru.
Stem cell therapy in dogs has increased considerably in recent years; however, there are few publications on the treatment of perianal fistulas (PF) in this species. The aim of this open-label clinical trial was to demonstrate the efficacy and safety of a new protocol for the in situ administration of low-dose adipose-derived allogeneic stem cells (ASCs) for the treatment of refractory spontaneous perianal fistula. The methodology consisted of applying one to three doses of 5 × 10 cryopreserved allogeneic ASCs to each fistula.
View Article and Find Full Text PDFTOpClass Class 4 Perineal Crohn's Disease: A Systematic Review and Meta-analysis of Perineal Wound Complication After Proctectomy in Crohn's Patients.
Inflamm Bowel Dis
October 2024
Department of Colon and Rectal Surgery, Cleveland Clinic Foundation, Cleveland, OH, USA.
Background: Nonhealing perineal wounds have been reported to be common after proctectomy for Crohn's disease (CD). We performed a systematic review and meta-analysis of perineal wound healing after proctectomy for CD and assessed the risk factors for nonhealing.
Methods: A comprehensive literature search was conducted in PubMed, Embase, and Scopus databases from 2010 to 2023, and articles reporting perineal wound healing rates after proctectomy for CD were included.
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