ArticleInternational journal of colorectal disease2025
Characteristics and surgical outcomes of small intestine-rectal fistulas in patients with Crohn's disease.
Article in International journal of colorectal disease, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeSmall intestine-rectal fistulas are a rare and complex complication in Crohn's disease, posing significant diagnostic and management challenges. This study aims to investigate their distinctive features and evaluates surgical outcomes.
methodsWe conducted a retrospective analysis of Crohn's disease patients with small intestine-rectal fistulas who underwent surgery from January 2019 to March 2023. Data on disease characteristics, postoperative quality of life, and functional outcomes were collected.
resultsA total of 92 patients were included, predominantly male (75%). The average time from Crohn's disease diagnosis to small intestine-rectal fistula diagnosis was 5.18 years. Most fistulas originated in the ileum (84.79%), followed by the rectum (9.78%) and both sites (5.43%). Nearly half had perianal lesions (48.91%), with some also having entero-vesical fistulas (22.83%) and entero-vaginal fistulas (1.09%). Significant risk factors for the creation of temporary protective ileostomy included preoperative hemoglobin levels below 100 g/L, albumin levels below 35 g/L, and the presence of perianal disease. Fistulas originating from the rectum and rectal lesions of 3 cm or longer were significant risk factors for rectal resection. No small intestine-rectal fistula recurrence was observed over an average follow-up of 2.35 years. Patients without a permanent sigmoidostomy after small intestine-rectal fistula resection had better stool scores and improved quality of life, especially in emotional and social functioning.
conclusionsSmall intestine-rectal fistulas in Crohn's disease have distinct characteristics. Surgical repair and resection effectively restore intestinal continuity and improve quality of life, particularly when anal function is preserved.
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