ArticleIndian journal of gastroenterology : official journal of the Indian Society of Gastroenterology2020
Long-term outcomes in perianal fistulizing Crohn's disease in a resource-limited setting: A cohort analysis.
Article in Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it, 17 citations in OpenAlex.
- Perianal fistulizing Crohn's disease: Clinical practice update from Colitis and Crohn's Foundation (India).Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2026Guideline
- A phase I/II clinical trial of ex-vivo expanded human bone marrow derived allogeneic mesenchymal stromal cells in adult patients with perianal fistulizing Crohn's Disease.Stem cell research & therapy · 2024Trial
- Epidemiology, treatment patterns, and associated risk factors in perianal fistulizing Crohn's disease: A systematic literature review.World journal of gastrointestinal surgery · 2025Article
- Prediction of postoperative recurrence of perianal fistulizing Crohn's disease by fecal calprotectin combined with serum miRNA6086.The Journal of international medical research · 2025Article
- Perianal fistulizing Crohn's disease: Current perspectives on diagnosis, monitoring and management with a focus on emerging therapies.Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2024Review
- Clinical and magnetic resonance imaging spectrum of complex perianal fistulizing Crohn's disease: A cohort study from northern India.Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2023Article
- The Optimal Management of Fistulizing Crohn's Disease: Evidence beyond Randomized Clinical Trials.Journal of clinical medicine · 2022Review
- Perianal and Luminal Relapse Following Perianal Surgical Intervention in Crohn's Disease.International journal of general medicine · 2021Article
- Indian Journal of Gastroenterology September-October 2020.Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2020Article
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Authors and funding
11 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPerianal fistula is one of the most challenging complications of Crohn's disease (CD). We aimed to describe treatment response with surgical and medical therapies, and long-term complications.
methodsWe retrospectively analyzed records of patients with perianal fistulizing CD who were prospectively followed from January 2005 to December 2018.
resultsAmong 807 patients, 81 (10%) had perianal fistula and 65 were included in the final analysis. The mean age of presentation was 27.4 ± 10.3 years, and 78.5% were males with a median duration of follow-up of 45 (IQR, 24-66) months. 75.4% (n = 49) had complex fistulae. 55.4% (n = 36) of patients received multiple courses (> 5 courses) of antibiotics. Complete response rates with immunomodulators, fistula surgery, biologicals, and diversion were 25%, 42.8%, 39.5%, and 45.4%, respectively. The relapse rate was highest after fistula surgery (52.6%). 44.6% of patients received medical (immunomodulators-21 and biologicals-8) whereas 46.1% received surgery as the first-line therapy. The absence of perianal abscess was associated with complete fistula closure. One patient developed malignancy and 4 (6.1%) died at the end of follow-up. Among the patients (n = 28) who received biologicals, TB reactivation occurred in one patient (3.5%).
conclusionMedical therapy should be offered as first-line therapy, and immunomodulators can be considered when patients cannot afford biologicals. Surgery offers temporary improvement and is associated with high relapse rates. Absence of perianal abscess predicts long-term complete fistula closure.
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