Perianal fistulas in Crohn's disease (review)

Treatment of аnal fistulas as perianal manifestations of Crohn’s disease is an important task, the solution of which has not yet been found. First of all, this is due to debilitating symptoms that reduce the quality of life. Incorrect tactics in the treatment of this disease can lead to the development of anal incontinence, and in some cases to the removal of the rectum. The purpose of this review was to study the effectiveness of various surgical methods for the treatment of perianal fistulas, the features of their use in various types of fistulas, as well as to assess the impact of surgical treatment on the function of the anal sphincter. It was found that most of the described methods were used in a strictly selected limited group of patients and allowed only temporary elimination of the clinical manifestations of Crohn’s disease. Unsatisfactory results of treatment, especially in the late postoperative period, a small number of clinical observations in published scientific papers on the treatment of perianal manifestations of Crohn’s disease, as well as low reliability of the results, dictate the need for further studies involving more patients.