Seton drainage combined with anti-tnf therapy for perianal fistulizing Crohn’s disease, single center experience

79 - 83, 15.05.2016

Samet Yardımcı , Yalçın Kara Wafi Attaallah Mustafa Uğurlu Şevket Yeğen

https://doi.org/10.5472/MMJoa.2902.03

Cited By: 1

Abstract

Perianal fistulizan Crohn hastalığında combine seton drenaj ve anti-TNF tedavi sonuçları, tek merkez deneyimi

Abstract

Amaç: Bu çalışmanın amacı perianal Crohn hastalığında, kombine seton ve anti tümör nekroz faktörü (TNF) ajanlarla yapılan tedavinin etkinliğini değerlendirmektir. Hastalar ve Yöntem: Ocak 2013 ve Kasım 2014 tarihleri arasında kombine seton drenaj ve anti-TNF tedavisi uygulanmış ardışık 27 perianal fistülizan Crohn hastası çalışmaya dahil edildi. Tüm hastalar standart pelvik manyetik rezonans görüntüleme (MRG) ile incelendi. Hasta özellikleri, takip zamanı, pelvik MRG bulguları, kolonoskopi ve genel anestezi altında rektal muayene bulguları, kaydedildi. Takip süresinin sonunda tedaviye yanıt değerlendirildi. Bulgular: Tedavi sonrası ortanca takip süresi 17 ay idi. Hastaların 24 (%89)’ünde fistül kompleks yapıda idi. Kolonoskopi bulgularına göre 16 (%59,3) hastada ileit, 9 (%33,3) hastada aktif proktit saptandı. On iki (%44,4) hastada perianal apse gözlendi. Tedaviye tam yanıt 17 hastada elde edilirken, çalışma sürecinde sadece 3 (%11,1) hastada tekrarlayan perianal apse ile karşılaşıldı. Değerlendirdiğimiz faktörlerden hiçbiri komplet yanıt ile anlamlı olarak ilişkili bulunmadı. Sonuç: Crohn hastalığı ile ilişkili kompleks perianal fistülde kombine seton ve anti-TNF tedavi ile hastaların % 63’ünde tedaviye tam yanıt sağlanmıştır

Keywords

Crohn hastalığı, Perianal fistül, Seton, Infliximab

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