Universitatea de Stat de Medicină şi Farmacie "Nicolae Testemiţanu"
Abstract
Surgical Department 2, State University of Medicine and Pharmaceutics «Nicolae Testemitanu», Chisinau, Congresul consacrat aniversării a 75-a de la fondarea Universității de Stat de Medicină și Farmacie „Nicolae Testemițanu” din Republica Moldova, Ziua internațională a științei pentru pace și dezvoltareIntroduction. Perianal Crohn's disease (pCD)
is a chronic inflammation of anal region,
manifested by fissures, fistulas, abscesses or
strictures. It is a marker of severe CD,
associating with multiple relapses and
operations. Can evolve in isolation (25%) or
strike intestinal CD (75%). Correct early
diagnosis, timed surgical implications
constitute preconditions for success in the
treatment of pCD.
Purpose. Improvement of the diagnosis, of
the early and late postoperative results in
Perianal Crohn's disease (pCD).
Material and methods. Retrospective study
(2000-2019), based on the analysis of clinical
observation files, results of paraclinical
explorations and treatment of 52 patients
with pCD. The investigation program was
included: examination under anesthesia;
endoscopy; imaging modalities (MRI, CT,
fistulography, endorectal USG); histological
explorations (biopsy, specimens).
Conservative treatment was according to
ECCO Protocol(2012).
Results. Based on clinical, radiological,
endoscopic and histological data, the
definite diagnosis of pCD was possible in
72.7% of cases. Were operated 21
patients with pCD – drainage of perianal
abscess (2), closure of the
transphincterian fistula on Seton (6),
fistulotomy (2), fistulectomy (3), closure
of the recto-vaginal (2) or
extrasphincterian (3) fistula with
"advancement mucous flap", ileostomy
(1), rectal resection with anastomosis
(1), procectomy (1).
Conclusions. The surgical attitude,
individualized in each case, associated
with biological therapy (infliximab),
allows the essential reduction of
relapses (23.8%), postoperative
complications (14.3%) and lethality
(4.8%)
