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©2009 The WJG Press and Baishideng.
World J Gastroenterol. Sep 14, 2009; 15(34): 4263-4272
Published online Sep 14, 2009. doi: 10.3748/wjg.15.4263
Published online Sep 14, 2009. doi: 10.3748/wjg.15.4263
Intervention reference | Study design and patients | Main findings |
Topical tacrolimus | ||
Casson et al[63], 2000 | Case study of series of pediatric Crohn’s patients including 1 patient with perianal fistula | Response reported in patient with perianal fistula |
Hart et al[64], 2007 | Randomized, placebo-controlled study in 19 patients (12 Crohn’s) | Treatment found not to be beneficial in perianal fistulas |
Fibrin glue | ||
Abel et al[79], 1993 | Uncontrolled study of use of fibrin glue in 10 patients (2 Crohn’s) | 0/2 patients with Crohn’s disease achieved healing |
Cintron et al[80], 2000 | 79 patients (6 Crohn’s) assigned to 3 types of fibrin glue treatment | 2/6 Crohn’s patients (33%) achieved healing (no drainage) |
Lindsey et al[66], 2002 | Randomized trial comparing fibrin glue with conventional surgery (fistulotomy or loose seton placement) in 42 patients (6 Crohn’s and complex perianal fistula) | Healing (no drainage) in 2/6 Crohn’s patients (33%) who received fibrin glue. No Crohn’s patients received conventional surgery |
Sentovich[81], 2003 | Uncontrolled study: 48 patients (5 Crohn’s) underwent seton placement followed by instillation of fibrin glue | Healing in 4/5 (80%) Crohn’s patients |
Zmora et al[82], 2003 | Retrospective review of 37 patients with perineal fistula (7 Crohn’s) treated with fibrin glue | Healing in 3/7 Crohn’s patients (43%) (2 patients also treated with endorectal advancement flap) |
Loungnarath et al[83], 2004 | Retrospective review of 42 patients with perianal fistula (13 Crohn’s) treated with fibrin glue | Lasting fistula healing in 4/13 (31%) |
Singer et al[84], 2005 | Randomized trial comparing fibrin glue + antibiotics, fibrin glue + surgery, and fibrin glue + antibiotic and surgery in 75 patients (3 Crohn’s) | Treatment failed in all 3 Crohn’s patients (fibrin glue + antibiotic in 1 patient and fibrin + antibiotic and surgery in 2 patients) |
Intralesional infliximab | ||
Poggioli et al[68], 2005 | Uncontrolled study of 15 Crohn’s patients with complex perianal fistulas | Healing in 10/15 patients after 3-12 infusions |
Asteria et al[69], 2006 | Uncontrolled study of 11 Crohn’s patients with complex perianal fistulas naïve to infliximab | 8/11 patients responded (≥ 50% reduction in fistula drainage) to treatment |
Adipose-derived stem cell (ASC) therapy with fibrin glue | ||
García-Olmo et al[72], 2005 | Uncontrolled proof-of-concept study in patients with fistulizing Crohn’s disease, including 1 perineal fistula | Perineal fistula healed after 8 wk |
Garcia-Olmo et al[73], 2009 | Randomized controlled phase II study comparing fibrin glue + ASCs with fibrin glue in 49 patients with complex perianal fistula (14 Crohn’s) | Healing in 5/7 Crohn’s patients (71%) in fibrin glue + ASCs group compared to 1/7 (14%) in the control group |
Fistula plugs | ||
O’Connor et al[75], 2006 | Uncontrolled study of fistula plug in 20 Crohn’s patients with fistula tracts not amenable to fistulotomy | Success rate of 80%, lower in the case of complex fistulas |
Schwandner et al[76], 2008 | Uncontrolled study of 19 patients (7 Crohn’s) with transsphincteric anorectal fistulas | Treatment success in 6/7 patients with Crohn’s disease (86%) |
Ky et al[77], 2008 | Prospective analysis of 45 patients (20 with complex fistulas and 14 with Crohn’s disease) receiving anal fistula plug | Healing in 4/14 Crohn’s patients (29%) after a median follow-up of 6.5 mo |
- Citation: Taxonera C, Schwartz DA, García-Olmo D. Emerging treatments for complex perianal fistula in Crohn’s disease. World J Gastroenterol 2009; 15(34): 4263-4272
- URL: https://www.wjgnet.com/1007-9327/full/v15/i34/4263.htm
- DOI: https://dx.doi.org/10.3748/wjg.15.4263