Healing of transsphincteric perianal fistulas in Crohn's disease using a new technique.

Objectives: Transsphincteric perianal fistulas in Crohn's disease are often refractory to medical therapy and difficult to treat surgically. Our objective was to determine whether a new method of anal fistulotomy was effective in healing these fistulas.

Methods: In this new method, the internal opening of the fistula tract was displaced distally to the region of the anal mucosa in 26 patients with Crohn's disease.

Results: Healing was achieved within 5 weeks of surgery in 45/49 (92%) of the fistulas and was not influenced by perioperative medication, site of preexisting Crohn's disease, or condition of the rectum. There has been no alteration of preoperative continence.

Conclusions: We conclude that this method is highly effective in treating transsphincteric perianal fistulas in Crohn's disease.