Abstract
Medical management of anal abscesses and perianal fistulas depends on their etiology. In most cases drugs are only used as a bridge to surgery or as supportive therapy in immunosuppressed patients with systemic septic complications. The only etiology that needs specific and advanced medical therapies before any surgical treatment is Crohn’s disease (CD). CD-related perianal disease is an aggressive, recurrent, and progressive phenotype that negatively impacts on the quality of life of affected patients. In CD a multidisciplinary evaluation is needed because an exclusive surgical approach usually does not achieve long-lasting results. Anti-TNF agents combined with advanced surgical techniques are gold-standard therapies in perianal fistulizing Crohn’s disease (PFCD). Other medical treatments have been studied with mixed results. The most promising treatment in recurrent PFCD refractory to standard care is the injection of mesenchymal stem cells (MSCs) in fistula tracts.
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Vetrone, L.M., Schepis, T., Privitera, G., Pugliese, D., Armuzzi, A. (2021). Integration of Surgery with Medical Therapy in Treating Anal Fistulas. In: Ratto, C., Parello, A., Litta, F., De Simone, V., Campennì, P. (eds) Anal Fistula and Abscess. Coloproctology. Springer, Cham. https://doi.org/10.1007/978-3-030-30902-2_36-1
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DOI: https://doi.org/10.1007/978-3-030-30902-2_36-1
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