Evidence map›Paper›PMID 42128973›Full record

ArticleTechniques in coloproctology2026

Fistulotomy for superficial or minimal sphincter-involving fistulae in perianal Crohn's disease: do they heal?

Oscar Hernandez Dominguez, Janell Holloway, Anuradha Bhama, Benjamin L Cohen, Leonardo Duraes, Arielle Kanters, Olga Lavryk, Jeremy Lipman, David Liska, Stefan D Holubar

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In one paragraph

Article in Techniques in coloproctology, 2026. 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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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

10 authors.

Oscar Hernandez DominguezDigestive Diseases Institute, Cleveland Clinic Main Campus, Cleveland Clinic Foundation, Cleveland Clinic Lerner College of Medicine and Case Western Reserve University, 9500 Euclid Ave, Cleveland, OH, A3044122, USA.
Janell HollowayDigestive Diseases Institute, Cleveland Clinic Main Campus, Cleveland Clinic Foundation, Cleveland Clinic Lerner College of Medicine and Case Western Reserve University, 9500 Euclid Ave, Cleveland, OH, A3044122, USA.
Anuradha BhamaDigestive Diseases Institute, Cleveland Clinic Main Campus, Cleveland Clinic Foundation, Cleveland Clinic Lerner College of Medicine and Case Western Reserve University, 9500 Euclid Ave, Cleveland, OH, A3044122, USA.
Benjamin L CohenDigestive Diseases Institute, Cleveland Clinic Main Campus, Cleveland Clinic Foundation, Cleveland Clinic Lerner College of Medicine and Case Western Reserve University, 9500 Euclid Ave, Cleveland, OH, A3044122, USA.
Leonardo DuraesDigestive Diseases Institute, Cleveland Clinic Main Campus, Cleveland Clinic Foundation, Cleveland Clinic Lerner College of Medicine and Case Western Reserve University, 9500 Euclid Ave, Cleveland, OH, A3044122, USA.
Arielle KantersDigestive Diseases Institute, Cleveland Clinic Main Campus, Cleveland Clinic Foundation, Cleveland Clinic Lerner College of Medicine and Case Western Reserve University, 9500 Euclid Ave, Cleveland, OH, A3044122, USA.
Olga LavrykDigestive Diseases Institute, Cleveland Clinic Main Campus, Cleveland Clinic Foundation, Cleveland Clinic Lerner College of Medicine and Case Western Reserve University, 9500 Euclid Ave, Cleveland, OH, A3044122, USA.
Jeremy LipmanDigestive Diseases Institute, Cleveland Clinic Main Campus, Cleveland Clinic Foundation, Cleveland Clinic Lerner College of Medicine and Case Western Reserve University, 9500 Euclid Ave, Cleveland, OH, A3044122, USA.
David LiskaDigestive Diseases Institute, Cleveland Clinic Main Campus, Cleveland Clinic Foundation, Cleveland Clinic Lerner College of Medicine and Case Western Reserve University, 9500 Euclid Ave, Cleveland, OH, A3044122, USA.
Stefan D HolubarDigestive Diseases Institute, Cleveland Clinic Main Campus, Cleveland Clinic Foundation, Cleveland Clinic Lerner College of Medicine and Case Western Reserve University, 9500 Euclid Ave, Cleveland, OH, A3044122, USA. holubas@ccf.org.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundFistulotomy is highly effective (> 90%) for cryptoglandular fistula-on-ano, but fistulotomy in perianal Crohn's disease (pCD) is limited due to increased risk of recurrent fistulae, diarrhea, and fecal incontinence. We hypothesized that superficial fistulotomy resulted in wound healing in most patients.

methodWe conducted a single-center retrospective review of adult patients with pCD who underwent fistulotomy from 1999 to 2022. Baseline characteristics, pCD characteristics, and short- and long-term surgical and functional outcomes were reported. Matched-pair Wilcoxon signed-rank test was used to compare continuous data.

resultsA total of 43 adult patients with pCD underwent fistulotomy and were included: 29 (67.4%) were male, with an age of 34 (28-42) years and a follow-up time of 4.3 years. Prior interventions included draining setons (48.8%) and partial fistulotomy (17.4%); 25.6% had no prior surgery. Fistulotomies were subcutaneous (65.1%), low transsphincteric (16.3%), intersphincteric (4.7%), and unspecified (14%). Short-term complications included pain (20.9%), bleeding (4.7%), and seepage (2.3% each), and 58.1% of the patients had no complications. Long-term complications included bleeding, keyhole deformity, nonhealing wounds, and anal stricture (2.3% each), and 60.5% did not experience long-term complications. At the last follow-up, 41 (95.3%) patients had complete healing of the fistulotomy site.

conclusionsFistulotomy was safe in select patients with fistulizing pCD and superficial fistulas with little or no sphincter involvement. We observed that fistulotomy was associated with wound healing, decreased drainage, and social restrictions in most patients, suggesting that this is a viable and safe option for this at-risk group.

Indexed as

Anal CanalCrohn DiseaseRectal FistulaSphincterotomyWound HealingAdultFemaleFollow-Up StudiesHumansMaleRecurrenceRetrospective StudiesTreatment OutcomeFecal incontinenceFistula-in-anoFistulotomyInflammatory bowel diseasePerianal Crohn’s disease

Identifiers

PMID42128973
PMCPMC13341898

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.