Surgical and biological treatment of perianal Crohn disease: LTP54


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Abstract

Aim:Fistulas are most common symptoms of perianal Crohn's disease. Surgical treatment combined with antiTNF-alfa antibodies such as infliximab (IFX) or adalimumab have become a new mode of therapy in fistulising Crohn's disease, which allows to achieve clinical remission. Present the own reults in cpmbined treatment of Crohn's perianal fistulas.Method:Thirty-four patients with Crohn's perianal fistulas have been hospitalized in the period of 2006-2009. Fistulography, endorectal ultrasound with H2O2 have been done inpreop period. Twenty patients (nine females, 11 males, at the age of 16-47) have been enrolled to IFX trial after surgical treatment. All of the patients underwent surgicalprocedures - non-cuting setons were placed during EUA.Results:Every patient showed clinical response to IFX therapy. More than 50% of fistulas closed spontaneously at week 10. CRP were normalized. CDAI and PDAI significantly reduced. After 30 weeks 82.7% of perianal fistulas have been closed.Conclusion:The efficacy of IFX was confirmed in numerous clinical studies. The use of IFX after surgery is indicated in patients showing no response to standard therapeuticprocedures. It's a good alternative to all remaining methods and allows to close perianal fistulas during short period and increase QoL among Crohn's patients.

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