Surgical Management of Complex Enteric Fistulas in Crohn's Disease

Abstract

Crohn's disease is a chronic, inflammatory bowel condition that can affect the entire digestive tract and in many cases lead to enteric fistula formation. The management of enteric fistulas can be challenging and often requires a multidisciplinary approach.

Keywords

enterocutaneos fistula - Crohn’s disease - abdominal fistula

• References

• 1 Strong S, Steele SR, Boutrous M. , et al; Clinical Practice Guidelines Committee of the American Society of Colon and Rectal Surgeons. Clinical practice guideline for the surgical management of Crohn's disease. Dis Colon Rectum 2015; 58 (11) 1021-1036
• 2 Center For Disease Control C. Prevention. Epidemiology of IBD. 2015; 2017. https://www.cdc.gov/ibd/IBD-epidemiology.htm
• 3 Louis E. Epidemiology of the transition from early to late Crohn's disease. Dig Dis 2012; 30 (04) 376-379
• 4 Bouguen G, Peyrin-Biroulet L. Surgery for adult Crohn's disease: what is the actual risk?. Gut 2011; 60 (09) 1178-1181
• 5 Torres J, Mehandru S, Colombel JF, Peyrin-Biroulet L. Crohn's disease. Lancet 2017; 389 (10080): 1741-1755
• 6 Al-Hawary M, Zimmermann EM. A new look at Crohn's disease: novel imaging techniques. Curr Opin Gastroenterol 2012; 28 (04) 334-340
• 7 Minordi LM, Vecchioli A, Poloni G, Guidi L, De Vitis I, Bonomo L. Enteroclysis CT and PEG-CT in patients with previous small-bowel surgical resection for Crohn's disease: CT findings and correlation with endoscopy. Eur Radiol 2009; 19 (10) 2432-2440
• 8 Vogel J, da Luz Moreira A, Baker M. , et al. CT enterography for Crohn's disease: accurate preoperative diagnostic imaging. Dis Colon Rectum 2007; 50 (11) 1761-1769
• 9 Seastedt KP, Trencheva K, Michelassi F. , et al. Accuracy of CT enterography and magnetic resonance enterography imaging to detect lesions preoperatively in patients undergoing surgery for Crohn's disease. Dis Colon Rectum 2014; 57 (12) 1364-1370
• 10 Jaffe TA, Gaca AM, Delaney S. , et al. Radiation doses from small-bowel follow-through and abdominopelvic MDCT in Crohn's disease. AJR Am J Roentgenol 2007; 189 (05) 1015-1022
• 11 Jensen MD, Ormstrup T, Vagn-Hansen C, Østergaard L, Rafaelsen SR. Interobserver and intermodality agreement for detection of small bowel Crohn's disease with MR enterography and CT enterography. Inflamm Bowel Dis 2011; 17 (05) 1081-1088
• 12 Fiorino G, Bonifacio C, Peyrin-Biroulet L. , et al. Prospective comparison of computed tomography enterography and magnetic resonance enterography for assessment of disease activity and complications in ileocolonic Crohn's disease. Inflamm Bowel Dis 2011; 17 (05) 1073-1080
• 13 Corman ML, Nicholls RJ, Fazio VW, Bergamaschi R. Corman's Colon and Rectal Surgery. 6th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2012
• 14 Sampietro GM, Casiraghi S, Foschi D. Perforating Crohn's disease: conservative and surgical treatment. Dig Dis 2013; 31 (02) 218-221
• 15 de Campos-Lobato LuizF, Wells B, Wick E. , et al. Predicting organ space surgical site infection with a nomogram. J Gastrointest Surg 2011; 15 (03) 540
• 16 Chapman R, Foran R, Dunphy JE. Management of intestinal fistulas. Am J Surg 1964; 108: 157-164
• 17 Felipe de Campos-Lobato L, Vogel JD. Enterocutaneous fistula associated with malignancy and prior radiation therapy. Clin Colon Rectal Surg 2010; 23 (03) 176-181
• 18 Strong S. Crohn's disease: surgical management. In: Beck DE, Roberts PL, Saclarides TJ, Senagore AJ, Stamos MJ, Wexner SD. , eds. The ASCRS Textbook of Colon and Rectal Surgery. 2nd ed. New York: Springer; 2011: 499-516
• 19 Clancy C, Boland T, Deasy J, McNamara D, Burke JP. A meta-analysis of percutaneous drainage versus surgery as the initial treatment of Crohn's disease-related intra-abdominal abscess. J Crohn's Colitis 2016; 10 (02) 202-208
• 20 He X, Lin X, Lian L. , et al. Preoperative percutaneous drainage of spontaneous intra-abdominal abscess in patients with Crohn's disease: a meta-analysis. J Clin Gastroenterol 2015; 49 (09) e82-e90
• 21 Nguyen GC, Munsell M, Harris ML. Nationwide prevalence and prognostic significance of clinically diagnosable protein-calorie malnutrition in hospitalized inflammatory bowel disease patients. Inflamm Bowel Dis 2008; 14 (08) 1105-1111
• 22 Forbes A, Escher J, Hébuterne X. , et al. ESPEN guideline: clinical nutrition in inflammatory bowel disease. Clin Nutr 2017; 36 (02) 321-347
• 23 Gomollón F, Dignass A, Annese V. , et al; ECCO. 3rd European Evidence-based Consensus on the Diagnosis and Management of Crohn's Disease 2016: Part 1: Diagnosis and Medical Management. J Crohn's Colitis 2017; 11 (01) 3-25
• 24 Gionchetti P, Dignass A, Danese S. , et al; ECCO. 3rd European Evidence-based Consensus on the Diagnosis and Management of Crohn's Disease 2016: Part 2: surgical management and special situations. J Crohn's Colitis 2017; 11 (02) 135-149
• 25 Rozpondek P, Zwolińska-Wcisło M, Przybylska M, Mach T. Effectiveness of anti-TNF alpha antibodies in treatment of fistulizing Crohn's disease [in Polish]. Przegl Lek 2011; 68 (09) 602-605
• 26 Gómez-Senent S, Barreiro-de-Acosta M, García-Sánchez V. Enterocutaneous fistulas and Crohńs disease: clinical characteristics and response to treatment. Rev Esp Enferm Dig 2013; 105 (01) 3-6
• 27 Singh S, Ding NS, Mathis KL. , et al. Systematic review with meta-analysis: faecal diversion for management of perianal Crohn's disease. Aliment Pharmacol Ther 2015; 42 (07) 783-792
• 28 Hill GL. Operative strategy in the treatment of enterocutaneous fistulas. World J Surg 1983; 7 (04) 495-501
• 29 Runström B, Hallböök O, Nyström PO, Sjödahl R, Olaison G. Outcome of 132 consecutive reconstructive operations for intestinal fistula--staged operation without primary anastomosis improved outcome in retrospective analysis. Scand J Surg 2013; 102 (03) 152-157
• 30 Fazio VW, Wilk P, Turnbull Jr RB, Jagelman DG. The dilemma of Crohn's disease: ileosigmoidal fistula complicating Crohn's disease. Dis Colon Rectum 1977; 20 (05) 381-386
• 31 Sheen E, Huang RJ, Triadafilopoulos G. Two evils: gastrocolic fistula and heart failure. Dig Dis Sci 2014; 59 (05) 928-932
• 32 Yamamoto T, Bain IM, Connolly AB, Keighley MRB. Gastroduodenal fistulas in Crohn's disease: clinical features and management. Dis Colon Rectum 1998; 41 (10) 1287-1292
• 33 Steckstor M, Adam B, Pech O, Tannapfel A, Riphaus A. Gastroduodenal Crohn’s Disease. Video J Encycl GI Endosc 2013; 1 (01) 178-179
• 34 Melton GB, Stocchi L, Wick EC, Appau KA, Fazio VW. Contemporary surgical management for ileosigmoid fistulas in Crohn's disease. J Gastrointest Surg 2009; 13 (05) 839-845
• 35 Solem CA, Loftus Jr EV, Tremaine WJ, Pemberton JH, Wolff BG, Sandborn WJ. Fistulas to the urinary system in Crohn's disease: clinical features and outcomes. Am J Gastroenterol 2002; 97 (09) 2300-2305
• 36 Pechan J, Pindak D, Lutter I, Weibl P, Bernadic M, Bakos E. Enterovesical fistulas in Crohn's disease. Bratisl Lek Listy (Tlacene Vyd) 2007; 108 (07) 307-308
• 37 Taxonera C, Barreiro-de-Acosta M, Bastida G. , et al. Outcomes of medical and surgical therapy for entero-urinary fistulas in Crohn's disease. J Crohn's Colitis 2016; 10 (06) 657-662
• 38 Fazio VW, Jones IT, Jagelman DG, Weakley FL. Rectourethral fistulas in Crohn's disease. Surg Gynecol Obstet 1987; 164 (02) 148-150
• 39 Harper PH, Kettlewell MGW, Lee ECG. The effect of split ileostomy on perianal Crohn's disease. Br J Surg 1982; 69 (10) 608-610
• 40 Sonoda T, Hull T, Piedmonte MR, Fazio VW. Outcomes of primary repair of anorectal and rectovaginal fistulas using the endorectal advancement flap. Dis Colon Rectum 2002; 45 (12) 1622-1628
• 41 Takano S, Boutros M, Wexner SD. Gracilis muscle transposition for complex perineal fistulas and sinuses: a systematic literature review of surgical outcomes. J Am Coll Surg 2014; 219 (02) 313-323
• 42 Pitel S, Lefevre JH, Parc Y, Chafai N, Shields C, Tiret E. Martius advancement flap for low rectovaginal fistula: short- and long term results. Color Dis Jun 13 (06) e112-e115 . doi: 10.1111/j.1463-1318.2011.02544.x
• 43 Corte H, Maggiori L, Treton X, Lefevre JH, Ferron M, Panis Y. Rectovaginal Fistula: What Is the Optimal Strategy?: An Analysis of 79 Patients Undergoing 286 Procedures. Ann Surg 2015; 262 (05) 855-860 , discussion 860–861