HEALING OF TRANSSPHINCTERIC PERIANAL FISTULAS IN CROHNS-DISEASE USINGA NEW TECHNIQUE

Objectives: Transsphincteric perianal fistulas in Crohn's disease are often refractory to medical therapy and difficult to treat surgically. Our objective was to determine whether a new method of anal fistuloto my was effective in healing these fistulas. Methods: In this new metho d, the internal opening of the fistula tract was displaced distally to the region of the anal mucosa in 26 patients with Crohn's disease. Re sults: Healing was achieved within 5 weeks of surgery in 45/49 (92%) o f the fistulas and was not influenced by perioperative medication, sit e of preexisting Crohn's disease, or condition of the rectum. There ha s been no alteration of preoperative continence. Conclusions: We concl ude that this method is highly effective in treating transsphincteric perianal fistulas in Crohn's disease.