{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T15:41:20Z","timestamp":1791819680019,"version":"4.3.4"},"reference-count":132,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2004,5,10]],"date-time":"2004-05-10T00:00:00Z","timestamp":1084147200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2004,6,17]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>The management of perianal Crohn's disease is difficult. A wide variety of treatment options exist although few are evidence based.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A search was conducted using the National Library of Medicine for articles on perianal Crohn's disease and its incidence, classification, assessment and management.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results and conclusion<\/jats:title>\n                  <jats:p>Perianal Crohn's disease can manifest as skin tags, ulcers, fissures, abscesses, fistulas or stenoses. Improved radiological imaging with endoanal anal ultrasonography and magnetic resonance imaging has improved its assessment and may be used to predict outcome after surgery. Many treatment options exist. During acute complications they are generally aimed at resolving the immediate problem and limiting damage to anal and perianal tissues; this may be a \u2018bridge\u2019 to definitive treatment. The likelihood of success of definitive treatment must be weighed against the risk of complications, especially faecal incontinence.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1002\/bjs.4613","type":"journal-article","created":{"date-parts":[[2004,6,17]],"date-time":"2004-06-17T13:01:17Z","timestamp":1087477277000},"page":"801-814","source":"Crossref","is-referenced-by-count":140,"title":["Perianal Crohn's disease"],"prefix":"10.1093","volume":"91","author":[{"given":"B","family":"Singh","sequence":"first","affiliation":[{"name":"Department of Colorectal Surgery, John Radcliffe Hospital, Oxford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N J","family":"McC Mortensen","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, John Radcliffe Hospital, Oxford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D P","family":"Jewell","sequence":"additional","affiliation":[{"name":"Gastroenterology Unit, University of Oxford, Gibson Laboratories, Radcliffe Infirmary, Oxford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B","family":"George","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, John Radcliffe Hospital, Oxford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2004,5,10]]},"reference":[{"key":"2021070911511285800_bib1","doi-asserted-by":"crossref","first-page":"1323","DOI":"10.1001\/jama.1932.02740680019005","article-title":"Regional ileitis, a pathological and clinical entity","volume":"99","author":"Crohn","year":"1932","journal-title":"JAMA"},{"key":"2021070911511285800_bib2","first-page":"156","article-title":"Results of an experimental and histological investigation into seventy-five cases of rectal fistulae","volume":"14","author":"Gabriel","year":"1921","journal-title":"Proc R Soc Med"},{"key":"2021070911511285800_bib3","doi-asserted-by":"crossref","first-page":"867","DOI":"10.1097\/00000658-193811000-00007","article-title":"Perianal fistulae as a complication of regional ileitis","volume":"108","author":"Penner","year":"1938","journal-title":"Ann Surg"},{"key":"2021070911511285800_bib4","doi-asserted-by":"crossref","first-page":"1122","DOI":"10.1016\/S0140-6736(59)90104-7","article-title":"Anal lesions in Crohn's disease","volume":"ii","author":"Morson","year":"1959","journal-title":"Lancet"},{"key":"2021070911511285800_bib5","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1007\/BF02058706","article-title":"Perianal Crohn's disease. Results of local surgical treatment","volume":"39","author":"Sangwan","year":"1996","journal-title":"Dis Colon Rectum"},{"key":"2021070911511285800_bib6","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1007\/BF02587272","article-title":"Symposium. Crohn's disease: anal lesions","volume":"18","author":"Lockhart-Mummery","year":"1975","journal-title":"Dis Colon Rectum"},{"key":"2021070911511285800_bib7","first-page":"32","article-title":"Perianal lesions in Crohn's disease","volume":"17","author":"Fielding","year":"1972","journal-title":"J R Coll Surg Edinb"},{"key":"2021070911511285800_bib8","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1016\/S0039-6109(05)70279-6","article-title":"Anorectal Crohn's disease","volume":"81","author":"McClane","year":"2001","journal-title":"Surg Clin North Am"},{"key":"2021070911511285800_bib9","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1007\/BF02603444","article-title":"Anal complications in Crohn's disease","volume":"24","author":"Williams","year":"1981","journal-title":"Dis Colon Rectum"},{"key":"2021070911511285800_bib10","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1007\/BF01648416","article-title":"Current status and influence of operation on perianal Crohn's disease","volume":"1","author":"Keighley","year":"1986","journal-title":"Int J Colorectal Dis"},{"key":"2021070911511285800_bib11","doi-asserted-by":"crossref","first-page":"1133","DOI":"10.1136\/gut.52.8.1133","article-title":"Genotype\u2013phenotype analysis of the Crohn's disease susceptibility haplotype on chromosome 5q31","volume":"52","author":"Armuzzi","year":"2003","journal-title":"Gut"},{"key":"2021070911511285800_bib12","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1007\/BF02560279","article-title":"Anorectal Crohn's disease. A long-term perspective","volume":"28","author":"Wolff","year":"1985","journal-title":"Dis Colon Rectum"},{"key":"2021070911511285800_bib13","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1007\/BF02393577","article-title":"Perianal Crohn's disease","volume":"4","author":"Alexander-Williams","year":"1980","journal-title":"World J Surg"},{"key":"2021070911511285800_bib14","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1002\/bjs.1800750120","article-title":"Anal fissure in Crohn's disease","volume":"75","author":"Sweeney","year":"1988","journal-title":"Br J Surg"},{"key":"2021070911511285800_bib15","doi-asserted-by":"crossref","first-page":"1137","DOI":"10.1007\/BF02048328","article-title":"Anal fissure in Crohn's disease: a plea for aggressive management","volume":"38","author":"Fleshner","year":"1995","journal-title":"Dis Colon Rectum"},{"key":"2021070911511285800_bib16","doi-asserted-by":"crossref","first-page":"1084","DOI":"10.1016\/S0140-6736(77)92337-6","article-title":"Treatment of haemorrhoids in patients with inflammatory bowel disease","volume":"i","author":"Jeffery","year":"1977","journal-title":"Lancet"},{"key":"2021070911511285800_bib17","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1111\/j.1445-2197.1996.tb00690.x","article-title":"Anal pathology in patients with Crohn's disease","volume":"66","author":"Platell","year":"1996","journal-title":"Aust N Z J Surg"},{"key":"2021070911511285800_bib18","volume-title":"Surgery of the Anus, Rectum, and Colon","author":"Keighley","year":"1993"},{"key":"2021070911511285800_bib19","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1097\/00042737-199703000-00004","article-title":"Anal lesions: any significant prognosis in Crohn's disease?","volume":"9","author":"Siproudhis","year":"1997","journal-title":"Eur J Gastroenterol Hepatol"},{"key":"2021070911511285800_bib20","doi-asserted-by":"crossref","first-page":"1039","DOI":"10.1007\/BF02054696","article-title":"Evaluation of surgery for perianal Crohn's fistulas","volume":"39","author":"Scott","year":"1996","journal-title":"Dis Colon Rectum"},{"key":"2021070911511285800_bib21","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1007\/s003840050051","article-title":"Fistulae and abscesses in symptomatic perianal Crohn's disease","volume":"11","author":"Solomon","year":"1996","journal-title":"Int J Colorectal Dis"},{"key":"2021070911511285800_bib22","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1007\/BF02258390","article-title":"Perianal abscess in Crohn's disease","volume":"40","author":"Makowiec","year":"1997","journal-title":"Dis Colon Rectum"},{"key":"2021070911511285800_bib23","doi-asserted-by":"crossref","first-page":"906","DOI":"10.7326\/0003-4819-135-10-200111200-00011","article-title":"Diagnosis and treatment of perianal fistulas in Crohn disease","volume":"135","author":"Schwartz","year":"2001","journal-title":"Ann Intern Med"},{"key":"2021070911511285800_bib24","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1002\/bjs.1800680802","article-title":"Anal fistulas in Crohn's disease","volume":"68","author":"Marks","year":"1981","journal-title":"Br J Surg"},{"key":"2021070911511285800_bib25","doi-asserted-by":"crossref","first-page":"378","DOI":"10.1007\/BF02053687","article-title":"Fistula-in-ano in Crohn's disease. Results of aggressive surgical treatment","volume":"34","author":"Williams","year":"1991","journal-title":"Dis Colon Rectum"},{"key":"2021070911511285800_bib26","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1002\/bjs.1800630102","article-title":"A classification of fistula-in-ano","volume":"63","author":"Parks","year":"1976","journal-title":"Br J Surg"},{"key":"2021070911511285800_bib27","doi-asserted-by":"crossref","first-page":"644","DOI":"10.1177\/014107687807100904","article-title":"Surgical pathology and management of anorectal Crohn's disease","volume":"71","author":"Hughes","year":"1978","journal-title":"J R Soc Med"},{"key":"2021070911511285800_bib28","first-page":"43","article-title":"Outcome following treatment of anal fistulae in Crohn's disease","volume":"500","author":"Bergstrand","year":"1980","journal-title":"Acta Chir Scand Suppl"},{"key":"2021070911511285800_bib29","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1007\/BF02053858","article-title":"Factors related to frequency, type, and outcome of anal fistulas in Crohn's disease","volume":"38","author":"Halme","year":"1995","journal-title":"Dis Colon Rectum"},{"key":"2021070911511285800_bib30","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1007\/BF02054227","article-title":"Twenty-year review of the surgical management of perianal Crohn's disease","volume":"38","author":"Williamson","year":"1995","journal-title":"Dis Colon Rectum"},{"key":"2021070911511285800_bib31","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1007\/BF02562636","article-title":"Anovaginal and rectovaginal fistulas in Crohn's disease","volume":"31","author":"Radcliffe","year":"1988","journal-title":"Dis Colon Rectum"},{"key":"2021070911511285800_bib32","doi-asserted-by":"crossref","first-page":"893","DOI":"10.1007\/BF02053988","article-title":"Long-term results of ileal pouch\u2013anal anastomosis in patients with Crohn's disease","volume":"39","author":"Sagar","year":"1996","journal-title":"Dis Colon Rectum"},{"key":"2021070911511285800_bib33","doi-asserted-by":"crossref","first-page":"653","DOI":"10.1002\/bjs.1800750711","article-title":"Natural history and treatment of anorectal strictures complicating Crohn's disease","volume":"75","author":"Linares","year":"1988","journal-title":"Br J Surg"},{"key":"2021070911511285800_bib34","doi-asserted-by":"crossref","first-page":"928","DOI":"10.1007\/BF02253493","article-title":"Clinical classification of perianal Crohn's disease","volume":"35","author":"Hughes","year":"1992","journal-title":"Dis Colon Rectum"},{"key":"2021070911511285800_bib35","doi-asserted-by":"crossref","first-page":"639","DOI":"10.1007\/BF02605765","article-title":"Adenocarcinoma in perineal fistulas of Crohn's disease","volume":"24","author":"Chaikhouni","year":"1981","journal-title":"Dis Colon Rectum"},{"key":"2021070911511285800_bib36","doi-asserted-by":"crossref","first-page":"466","DOI":"10.1136\/bmj.2.5603.466","article-title":"Crohn's disease and carcinoma of colon","volume":"ii","author":"Perrett","year":"1968","journal-title":"BMJ"},{"key":"2021070911511285800_bib37","doi-asserted-by":"crossref","first-page":"992","DOI":"10.1007\/BF02237388","article-title":"Carcinoma arising in anorectal fistulas of Crohn's disease","volume":"41","author":"Ky","year":"1998","journal-title":"Dis Colon Rectum"},{"key":"2021070911511285800_bib38","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1097\/00004836-199501000-00008","article-title":"Usual therapy improves perianal Crohn's disease as measured by a new disease activity index. McMaster IBD Study Group","volume":"20","author":"Irvine","year":"1995","journal-title":"J Clin Gastroenterol"},{"key":"2021070911511285800_bib39","doi-asserted-by":"crossref","first-page":"774","DOI":"10.1001\/archsurg.137.7.774","article-title":"Perianal Crohn disease: a new scoring system to evaluate and predict outcome of surgical intervention","volume":"137","author":"Pikarsky","year":"2002","journal-title":"Arch Surg"},{"key":"2021070911511285800_bib40","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1007\/BF02552656","article-title":"Fistulography for fistula-in-ano. Is it useful?","volume":"28","author":"Kuijpers","year":"1985","journal-title":"Dis Colon Rectum"},{"key":"2021070911511285800_bib41","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1007\/BF02049995","article-title":"The role of fistulography in fistula-in-ano. Report of five cases","volume":"34","author":"Weisman","year":"1991","journal-title":"Dis Colon Rectum"},{"key":"2021070911511285800_bib42","doi-asserted-by":"crossref","first-page":"515","DOI":"10.1007\/BF02234179","article-title":"Endosonographic criteria for an internal opening of fistula-in-ano","volume":"42","author":"Cho","year":"1999","journal-title":"Dis Colon Rectum"},{"key":"2021070911511285800_bib43","doi-asserted-by":"crossref","first-page":"1375","DOI":"10.1007\/BF02236633","article-title":"How can the assessment of fistula-in-ano be improved?","volume":"43","author":"Ratto","year":"2000","journal-title":"Dis Colon Rectum"},{"key":"2021070911511285800_bib44","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1002\/bjs.1800780418","article-title":"Comparison between anal endosonography and digital examination in the evaluation of anal fistulae","volume":"78","author":"Choen","year":"1991","journal-title":"Br J Surg"},{"key":"2021070911511285800_bib45","doi-asserted-by":"crossref","first-page":"1057","DOI":"10.1007\/BF02236703","article-title":"Use of endoanal ultrasound in patients with rectovaginal fistulas","volume":"42","author":"Yee","year":"1999","journal-title":"Dis Colon Rectum"},{"key":"2021070911511285800_bib46","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1046\/j.1365-2168.1998.00616.x","article-title":"Vaginal endosonography of the anal sphincter complex is important in the assessment of faecal incontinence and perianal sepsis","volume":"85","author":"Poen","year":"1998","journal-title":"Br J Surg"},{"key":"2021070911511285800_bib47","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1097\/00054725-199908000-00012","article-title":"MRI scanning in perianal Crohn's disease: an important diagnostic adjunct","volume":"5","author":"Borley","year":"1999","journal-title":"Inflamm Bowel Dis"},{"key":"2021070911511285800_bib48","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1136\/gut.37.2.284","article-title":"High resolution magnetic resonance imaging of the anal sphincter using an internal coil","volume":"37","author":"deSouza","year":"1995","journal-title":"Gut"},{"key":"2021070911511285800_bib49","doi-asserted-by":"crossref","first-page":"1396","DOI":"10.1002\/bjs.1800831022","article-title":"Prospective evaluation of dynamic contrast enhanced magnetic resonance imaging in the evaluation of fistula in ano","volume":"83","author":"Beckingham","year":"1996","journal-title":"Br J Surg"},{"key":"2021070911511285800_bib50","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1136\/gut.36.3.407","article-title":"Pelvic and perineal complications of Crohn's disease: assessment using magnetic resonance imaging","volume":"36","author":"Haggett","year":"1995","journal-title":"Gut"},{"key":"2021070911511285800_bib51","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1046\/j.1365-2168.1998.00573.x","article-title":"Comparison of endoanal magnetic resonance imaging with surgical findings in perirectal sepsis","volume":"85","author":"Zbar","year":"1998","journal-title":"Br J Surg"},{"key":"2021070911511285800_bib52","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1097\/00004728-199805000-00004","article-title":"MRI of fistula-in-ano: a comparison of endoanal coil with external phased array coil techniques","volume":"22","author":"deSouza","year":"1998","journal-title":"J Comput Assist Tomogr"},{"key":"2021070911511285800_bib53","doi-asserted-by":"crossref","first-page":"708","DOI":"10.1007\/BF02054416","article-title":"Magnetic resonance imaging of fistula-in-ano","volume":"37","author":"Lunniss","year":"1994","journal-title":"Dis Colon Rectum"},{"key":"2021070911511285800_bib54","doi-asserted-by":"crossref","first-page":"360","DOI":"10.1046\/j.1365-2168.1999.01020.x","article-title":"Prospective comparison of endosonography, magnetic resonance imaging and surgical findings in anorectal fistula and abscess complicating Crohn's disease","volume":"86","author":"Orsoni","year":"1999","journal-title":"Br J Surg"},{"key":"2021070911511285800_bib55","doi-asserted-by":"crossref","first-page":"1064","DOI":"10.1053\/gast.2001.28676","article-title":"A comparison of endoscopic ultrasound, magnetic resonance imaging, and exam under anesthesia for evaluation of Crohn's perianal fistulas","volume":"121","author":"Schwartz","year":"2001","journal-title":"Gastroenterology"},{"key":"2021070911511285800_bib56","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1016\/0016-5085(94)90585-1","article-title":"Quality of life: a valid and reliable measure of therapeutic efficacy in the treatment of inflammatory bowel disease. Canadian Crohn's Relapse Prevention Trial Study Group","volume":"106","author":"Irvine","year":"1994","journal-title":"Gastroenterology"},{"key":"2021070911511285800_bib57","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1136\/gut.44.1.77","article-title":"Prospective comparison of faecal incontinence grading systems","volume":"44","author":"Vaizey","year":"1999","journal-title":"Gut"},{"key":"2021070911511285800_bib58","doi-asserted-by":"crossref","first-page":"1132","DOI":"10.1053\/gast.2000.18165","article-title":"Treatment of fistulizing Crohn's disease","volume":"119","author":"Lichtenstein","year":"2000","journal-title":"Gastroenterology"},{"key":"2021070911511285800_bib59","doi-asserted-by":"crossref","first-page":"1438","DOI":"10.1111\/j.1572-0241.2002.05685.x","article-title":"Prior bowel resections, perianal disease, and a high initial Crohn's disease activity index are associated with corticosteroid resistance in active Crohn's disease","volume":"97","author":"Gelbmann","year":"2002","journal-title":"Am J Gastroenterol"},{"key":"2021070911511285800_bib60","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1007\/s11938-002-0041-y","article-title":"Perianal Crohn's disease","volume":"5","author":"Basu","year":"2002","journal-title":"Curr Treat Options Gastroenterol"},{"key":"2021070911511285800_bib61","doi-asserted-by":"crossref","first-page":"775","DOI":"10.1016\/S0140-6736(75)92438-1","article-title":"Metronidazole for Crohn's disease","volume":"i","author":"Ursing","year":"1975","journal-title":"Lancet"},{"key":"2021070911511285800_bib62","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1016\/0016-5085(80)90155-9","article-title":"Healing of perineal Crohn's disease with metronidazole","volume":"79","author":"Bernstein","year":"1980","journal-title":"Gastroenterology"},{"key":"2021070911511285800_bib63","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1016\/S0016-5085(82)80332-6","article-title":"Metronidazole therapy for perineal Crohn's disease: a follow-up study","volume":"83","author":"Brandt","year":"1982","journal-title":"Gastroenterology"},{"key":"2021070911511285800_bib64","doi-asserted-by":"crossref","first-page":"219","DOI":"10.3109\/00365529109025034","article-title":"Neurophysiologic studies of patients with Crohn's disease on long-term treatment with metronidazole","volume":"26","author":"Stahlberg","year":"1991","journal-title":"Scand J Gastroenterol"},{"key":"2021070911511285800_bib65","first-page":"144","article-title":"Long-term treatment of perianal or fistulous Crohn's disease with ciprofloxacin","volume":"24","author":"Turunen","year":"1989","journal-title":"Scand J Gastroenterol"},{"key":"2021070911511285800_bib66","doi-asserted-by":"crossref","first-page":"981","DOI":"10.1056\/NEJM198005013021801","article-title":"Treatment of Crohn's disease with 6-mercaptopurine. A long-term, randomized, double-blind study","volume":"302","author":"Present","year":"1980","journal-title":"N Engl J Med"},{"key":"2021070911511285800_bib67","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1007\/BF01318372","article-title":"Favorable effect of 6-mercaptopurine on fistulae of Crohn's disease","volume":"30","author":"Korelitz","year":"1985","journal-title":"Dig Dis Sci"},{"key":"2021070911511285800_bib68","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1016\/0016-5085(91)90457-V","article-title":"Use of azathioprine or 6-mercaptopurine in the treatment of Crohn's disease","volume":"101","author":"O'Brien","year":"1991","journal-title":"Gastroenterology"},{"key":"2021070911511285800_bib69","doi-asserted-by":"crossref","first-page":"1347","DOI":"10.1016\/0016-5085(90)91160-8","article-title":"Long-term 6-mercaptopurine treatment in adolescents with Crohn's disease","volume":"99","author":"Markowitz","year":"1990","journal-title":"Gastroenterology"},{"key":"2021070911511285800_bib70","doi-asserted-by":"crossref","first-page":"294","DOI":"10.1097\/00004836-200004000-00018","article-title":"Azathioprine and 6-mercaptopurine for the treatment of perianal Crohn's disease in children","volume":"30","author":"Jeshion","year":"2000","journal-title":"J Clin Gastroenterol"},{"key":"2021070911511285800_bib71","doi-asserted-by":"crossref","first-page":"353","DOI":"10.7326\/0003-4819-110-5-353","article-title":"Methotrexate induces clinical and histologic remission in patients with refractory inflammatory bowel disease","volume":"110","author":"Kozarek","year":"1989","journal-title":"Ann Intern Med"},{"key":"2021070911511285800_bib72","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1056\/NEJM199502023320503","article-title":"Methotrexate for the treatment of Crohn's disease. The North American Crohn's Study Group Investigators","volume":"332","author":"Feagan","year":"1995","journal-title":"N Engl J Med"},{"key":"2021070911511285800_bib73","first-page":"646","article-title":"Rapid closure of Crohn's disease fistulas with continuous intravenous cyclosporin A","volume":"88","author":"Hanauer","year":"1993","journal-title":"Am J Gastroenterol"},{"key":"2021070911511285800_bib74","doi-asserted-by":"crossref","first-page":"374","DOI":"10.1007\/BF02090211","article-title":"Efficacy of cyclosporine in treatment of fistula of Crohn's disease","volume":"39","author":"Present","year":"1994","journal-title":"Dig Dis Sci"},{"key":"2021070911511285800_bib75","doi-asserted-by":"crossref","first-page":"2529","DOI":"10.1111\/j.1572-0241.1998.00606.x","article-title":"Mycophenolate mofetil in patients with Crohn's disease","volume":"93","author":"Fickert","year":"1998","journal-title":"Am J Gastroenterol"},{"key":"2021070911511285800_bib76","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1097\/00054725-200002000-00003","article-title":"Efficacy of mycophenolate mofetil in patients failing 6-mercaptopurine or azathioprine therapy for Crohn's disease","volume":"6","author":"Hassard","year":"2000","journal-title":"Inflamm Bowel Dis"},{"key":"2021070911511285800_bib77","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1097\/00054725-199911000-00001","article-title":"Combination therapy with oral tacrolimus (FK506) and azathioprine or 6-mercaptopurine for treatment-refractory Crohn's disease perianal fistulae","volume":"5","author":"Lowry","year":"1999","journal-title":"Inflamm Bowel Dis"},{"key":"2021070911511285800_bib78","doi-asserted-by":"crossref","first-page":"436","DOI":"10.1136\/gut.47.3.436","article-title":"Topical tacrolimus may be effective in the treatment of oral and perineal Crohn's disease","volume":"47","author":"Casson","year":"2000","journal-title":"Gut"},{"key":"2021070911511285800_bib79","doi-asserted-by":"crossref","first-page":"1029","DOI":"10.1056\/NEJM199710093371502","article-title":"A short-term study of chimeric monoclonal antibody cA2 to tumor necrosis factor alpha for Crohn's disease. Crohn's Disease cA2 Study Group","volume":"337","author":"Targan","year":"1997","journal-title":"N Engl J Med"},{"key":"2021070911511285800_bib80","doi-asserted-by":"crossref","first-page":"1330","DOI":"10.1053\/gast.2001.24042","article-title":"An engineered human antibody to TNF (CDP571) for active Crohn's disease: a randomized double-blind placebo-controlled trial","volume":"120","author":"Sandborn","year":"2001","journal-title":"Gastroenterology"},{"key":"2021070911511285800_bib81","doi-asserted-by":"crossref","first-page":"1398","DOI":"10.1056\/NEJM199905063401804","article-title":"Infliximab for the treatment of fistulas in patients with Crohn's disease","volume":"340","author":"Present","year":"1999","journal-title":"N Engl J Med"},{"key":"2021070911511285800_bib82","doi-asserted-by":"crossref","first-page":"3490","DOI":"10.1111\/j.1572-0241.2000.03366.x","article-title":"Clinical experience with infliximab therapy in 100 patients with Crohn's disease","volume":"95","author":"Farrell","year":"2000","journal-title":"Am J Gastroenterol"},{"key":"2021070911511285800_bib83","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1053\/gast.1999.0029900429","article-title":"Successful management of Crohn's disease of the ileoanal pouch with infliximab","volume":"117","author":"Ricart","year":"1999","journal-title":"Gastroenterology"},{"key":"2021070911511285800_bib84","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1007\/s10350-004-6111-6","article-title":"Endosonographic evidence of persistence of Crohn's disease-associated fistulas after infliximab treatment, irrespective of clinical response","volume":"45","author":"van Bodegraven","year":"2002","journal-title":"Dis Colon Rectum"},{"key":"2021070911511285800_bib85","doi-asserted-by":"crossref","first-page":"332","DOI":"10.1016\/S0002-9270(02)05909-9","article-title":"Magnetic resonance imaging of the effects of infliximab on perianal fistulizing Crohn's disease","volume":"98","author":"Van Assche","year":"2003","journal-title":"Am J Gastroenterol"},{"key":"2021070911511285800_bib86","doi-asserted-by":"crossref","first-page":"2022","DOI":"10.1111\/j.1572-0241.2002.05918.x","article-title":"Combining infliximab with 6-mercaptopurine\/azathioprine for fistula therapy in Crohn's disease","volume":"97","author":"Ochsenkuhn","year":"2002","journal-title":"Am J Gastroenterol"},{"key":"2021070911511285800_bib87","doi-asserted-by":"crossref","first-page":"1271","DOI":"10.1016\/S0016-5085(99)70276-3","article-title":"Thalidomide therapy for patients with refractory Crohn's disease: an open-label trial","volume":"117","author":"Ehrenpreis","year":"1999","journal-title":"Gastroenterology"},{"key":"2021070911511285800_bib88","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1007\/BF02054120","article-title":"Hyperbaric oxygenation in severe perineal Crohn's disease","volume":"38","author":"Colombel","year":"1995","journal-title":"Dis Colon Rectum"},{"key":"2021070911511285800_bib89","doi-asserted-by":"crossref","first-page":"756","DOI":"10.1016\/0016-5085(89)90649-5","article-title":"Healing of severe perineal and cutaneous Crohn's disease with hyperbaric oxygen","volume":"97","author":"Brady","year":"1989","journal-title":"Gastroenterology"},{"key":"2021070911511285800_bib90","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1023\/A:1027378532003","article-title":"Modification of in vivo and in vitro TNF-alpha, IL-1, and IL-6 secretion by circulating monocytes during hyperbaric oxygen treatment in patients with perianal Crohn's disease","volume":"17","author":"Weisz","year":"1997","journal-title":"J Clin Immunol"},{"key":"2021070911511285800_bib91","first-page":"42","article-title":"Techniques and results in the management of anal and perianal Crohn's disease","volume":"168","author":"Fry","year":"1989","journal-title":"Surg Gynecol Obstet"},{"key":"2021070911511285800_bib92","doi-asserted-by":"crossref","first-page":"933","DOI":"10.1007\/BF02139102","article-title":"Perirectal abscess in Crohn's disease. Drainage and outcome","volume":"33","author":"Pritchard","year":"1990","journal-title":"Dis Colon Rectum"},{"key":"2021070911511285800_bib93","doi-asserted-by":"crossref","first-page":"394","DOI":"10.1016\/0002-9610(80)90301-3","article-title":"Anorectal Crohn's disease: definitive surgery for fistulas and recurrent abscesses","volume":"139","author":"Sohn","year":"1980","journal-title":"Am J Surg"},{"key":"2021070911511285800_bib94","doi-asserted-by":"crossref","first-page":"587","DOI":"10.1007\/BF02052212","article-title":"Seton management of complex anorectal fistulas in patients with Crohn's disease","volume":"33","author":"White","year":"1990","journal-title":"Dis Colon Rectum"},{"key":"2021070911511285800_bib95","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1007\/BF02049864","article-title":"Role of the seton in the management of anorectal fistulas","volume":"36","author":"Pearl","year":"1993","journal-title":"Dis Colon Rectum"},{"key":"2021070911511285800_bib96","doi-asserted-by":"crossref","first-page":"1159","DOI":"10.1002\/bjs.1800781004","article-title":"Seton treatment of high anal fistulae","volume":"78","author":"Williams","year":"1991","journal-title":"Br J Surg"},{"key":"2021070911511285800_bib97","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1007\/BF02068077","article-title":"Long-term seton drainage for high anal fistulas in Crohn's disease\u2014a sphincter-saving operation?","volume":"39","author":"Faucheron","year":"1996","journal-title":"Dis Colon Rectum"},{"key":"2021070911511285800_bib98","doi-asserted-by":"crossref","first-page":"1063","DOI":"10.1046\/j.1365-2168.2000.01467.x","article-title":"Role of a defunctioning stoma in the management of large bowel Crohn's disease","volume":"87","author":"Edwards","year":"2000","journal-title":"Br J Surg"},{"key":"2021070911511285800_bib99","doi-asserted-by":"crossref","first-page":"492","DOI":"10.1007\/BF02554504","article-title":"Surgical management of anorectal fistulas in Crohn's disease","volume":"32","author":"Morrison","year":"1989","journal-title":"Dis Colon Rectum"},{"key":"2021070911511285800_bib100","first-page":"133","article-title":"Surgical treatment of anorectal fistula in patients with Crohn's disease","volume":"169","author":"Levien","year":"1989","journal-title":"Surg Gynecol Obstet"},{"key":"2021070911511285800_bib101","doi-asserted-by":"crossref","first-page":"847","DOI":"10.1007\/BF02554553","article-title":"Experience with perirectal fistulas in patients with Crohn's disease","volume":"32","author":"Fuhrman","year":"1989","journal-title":"Dis Colon Rectum"},{"key":"2021070911511285800_bib102","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1007\/BF00341224","article-title":"Anal fistulas in Crohn's disease: incidence and outcome of surgical treatment","volume":"7","author":"Nordgren","year":"1992","journal-title":"Int J Colorectal Dis"},{"key":"2021070911511285800_bib103","doi-asserted-by":"crossref","first-page":"577","DOI":"10.1007\/s10350-004-6611-4","article-title":"Combined seton placement, infliximab infusion, and maintenance immunosuppressives improve healing rate in fistulizing anorectal Crohn's disease: a single center experience","volume":"46","author":"Topstad","year":"2003","journal-title":"Dis Colon Rectum"},{"key":"2021070911511285800_bib104","doi-asserted-by":"crossref","first-page":"603","DOI":"10.1002\/bjs.1800820509","article-title":"Clinical course after transanal advancement flap repair of perianal fistula in patients with Crohn's disease","volume":"82","author":"Makowiec","year":"1995","journal-title":"Br J Surg"},{"key":"2021070911511285800_bib105","first-page":"147","article-title":"Endorectal advancement flap in perianal Crohn's disease","volume":"64","author":"Joo","year":"1998","journal-title":"Am Surg"},{"key":"2021070911511285800_bib106","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1016\/S0002-9610(99)00180-4","article-title":"Endoanal advancement flap repair for complex anorectal fistulas","volume":"178","author":"Hyman","year":"1999","journal-title":"Am J Surg"},{"key":"2021070911511285800_bib107","doi-asserted-by":"crossref","first-page":"919","DOI":"10.1007\/BF02554276","article-title":"The use of transanal rectal advancement flaps in the management of fistulas involving the anorectum","volume":"30","author":"Jones","year":"1987","journal-title":"Dis Colon Rectum"},{"key":"2021070911511285800_bib108","doi-asserted-by":"crossref","first-page":"1622","DOI":"10.1007\/s10350-004-7249-y","article-title":"Outcomes of primary repair of anorectal and rectovaginal fistulas using the endorectal advancement flap","volume":"45","author":"Sonoda","year":"2002","journal-title":"Dis Colon Rectum"},{"key":"2021070911511285800_bib109","doi-asserted-by":"crossref","first-page":"1616","DOI":"10.1007\/s10350-004-7248-z","article-title":"Endorectal advancement flap: are there predictors of failure?","volume":"45","author":"Mizrahi","year":"2002","journal-title":"Dis Colon Rectum"},{"key":"2021070911511285800_bib110","doi-asserted-by":"crossref","first-page":"681","DOI":"10.1007\/BF02235588","article-title":"Dermal island-flap anoplasty for transsphincteric fistula-in-ano: assessment of treatment failures","volume":"43","author":"Nelson","year":"2000","journal-title":"Dis Colon Rectum"},{"key":"2021070911511285800_bib111","doi-asserted-by":"crossref","first-page":"884","DOI":"10.1007\/BF02235371","article-title":"Cutaneous advancement flap closure: alternative method for treatment of complicated anal fistulas","volume":"41","author":"Robertson","year":"1998","journal-title":"Dis Colon Rectum"},{"key":"2021070911511285800_bib112","doi-asserted-by":"crossref","first-page":"1695","DOI":"10.1046\/j.1365-2168.1998.00959.x","article-title":"Advancement sleeve flaps for treatment of severe perianal Crohn's disease","volume":"85","author":"Marchesa","year":"1998","journal-title":"Br J Surg"},{"key":"2021070911511285800_bib113","doi-asserted-by":"crossref","first-page":"1032","DOI":"10.1007\/BF02049972","article-title":"Sleeve advancement anorectoplasty for complicated anorectal\/vaginal fistula","volume":"34","author":"Berman","year":"1991","journal-title":"Dis Colon Rectum"},{"key":"2021070911511285800_bib114","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1016\/S0002-9610(96)00420-5","article-title":"Surgical approaches to low anovaginal fistula in Crohn's disease","volume":"173","author":"Hull","year":"1997","journal-title":"Am J Surg"},{"key":"2021070911511285800_bib115","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1007\/BF00341278","article-title":"Treatment of anovaginal fistulas with an anocutaneous flap in patients with Crohn's disease","volume":"8","author":"Hesterberg","year":"1993","journal-title":"Int J Colorectal Dis"},{"key":"2021070911511285800_bib116","doi-asserted-by":"crossref","first-page":"641","DOI":"10.1007\/BF02050343","article-title":"Surgical repair of rectovaginal fistulas in patients with Crohn's disease: transvaginal approach","volume":"34","author":"Sher","year":"1991","journal-title":"Dis Colon Rectum"},{"key":"2021070911511285800_bib117","doi-asserted-by":"crossref","first-page":"1310","DOI":"10.1007\/BF02234789","article-title":"Reoperative abdominal and perineal surgery in ileoanal pouch patients","volume":"44","author":"Zmora","year":"2001","journal-title":"Dis Colon Rectum"},{"key":"2021070911511285800_bib118","doi-asserted-by":"crossref","first-page":"486","DOI":"10.1007\/BF02234173","article-title":"Transposition of the rectus abdominis muscle for complicated pouch and rectal fistulas","volume":"42","author":"Tran","year":"1999","journal-title":"Dis Colon Rectum"},{"key":"2021070911511285800_bib119","doi-asserted-by":"crossref","first-page":"528","DOI":"10.1002\/bjs.1800680803","article-title":"The incidence and course of perianal complications and arthralgia after intestinal resection with restoration of continuity for Crohn's disease","volume":"68","author":"Heuman","year":"1981","journal-title":"Br J Surg"},{"key":"2021070911511285800_bib120","doi-asserted-by":"crossref","first-page":"768","DOI":"10.1007\/BF02050327","article-title":"Factors predictive of persistent or recurrent Crohn's disease in excluded rectal segments","volume":"35","author":"Guillem","year":"1992","journal-title":"Dis Colon Rectum"},{"key":"2021070911511285800_bib121","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1007\/BF02235190","article-title":"Persistent perineal sinus after proctocolectomy for Crohn's disease","volume":"42","author":"Yamamoto","year":"1999","journal-title":"Dis Colon Rectum"},{"key":"2021070911511285800_bib122","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1080\/110241500750009311","article-title":"Gracilis transposition in complicated perianal fistula and unhealed perineal wounds in Crohn's disease","volume":"166","author":"Rius","year":"2000","journal-title":"Eur J Surg"},{"key":"2021070911511285800_bib123","doi-asserted-by":"crossref","first-page":"975","DOI":"10.1007\/BF02253501","article-title":"Low Hartmann's procedure for severe anorectal Crohn's disease","volume":"35","author":"Sher","year":"1992","journal-title":"Dis Colon Rectum"},{"key":"2021070911511285800_bib124","first-page":"627","article-title":"Laser ablation of complex perianal fistulas preserves continence and is a rectum-sparing alternative in Crohn's disease patients","volume":"64","author":"Bodzin","year":"1998","journal-title":"Am Surg"},{"key":"2021070911511285800_bib125","doi-asserted-by":"crossref","first-page":"1608","DOI":"10.1007\/s10350-004-7247-0","article-title":"A randomized, controlled trial of fibrin glue vs. conventional treatment for anal fistula","volume":"45","author":"Lindsey","year":"2002","journal-title":"Dis Colon Rectum"},{"key":"2021070911511285800_bib126","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1016\/S0140-6736(96)90243-3","article-title":"Treatment of Crohn's disease fistulas with coagulation factor XIII","volume":"347","author":"Oshitani","year":"1996","journal-title":"Lancet"},{"key":"2021070911511285800_bib127","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1056\/NEJM199901213400317","article-title":"Treatment of fistulas with granulocyte colony-stimulating factor in a patient with Crohn's disease","volume":"340","author":"Vaughan","year":"1999","journal-title":"N Engl J Med"},{"key":"2021070911511285800_bib128","doi-asserted-by":"crossref","first-page":"S95","DOI":"10.1002\/bjs.1800721349","article-title":"Anal lesions in Crohn's disease","volume":"72","author":"Lockhart-Mummery","year":"1985","journal-title":"Br J Surg"},{"key":"2021070911511285800_bib129","doi-asserted-by":"crossref","first-page":"914","DOI":"10.1016\/0016-5085(79)90391-3","article-title":"National Cooperative Crohn's Disease Study: extraintestinal manifestations and perianal complications","volume":"77","author":"Rankin","year":"1979","journal-title":"Gastroenterology"},{"issue":"2","key":"2021070911511285800_bib130","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1007\/BF01658054","article-title":"Management of perianal Crohn's disease","volume":"12","author":"Allan","year":"1988","journal-title":"World J Surg"},{"issue":"6","key":"2021070911511285800_bib131","doi-asserted-by":"crossref","first-page":"545","DOI":"10.1007\/BF02049859","article-title":"Surgery for symptomatic hemorrhoids and anal fissures in Crohn's disease","volume":"36","author":"Wolkomir","year":"1993","journal-title":"Dis Colon Rectum"},{"issue":"3","key":"2021070911511285800_bib132","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1016\/0016-5085(88)90243-0","article-title":"Local depot methylprednisolone injection for painful anal Crohn's disease","volume":"94","author":"Hughes","year":"1988","journal-title":"Gastroenterology"}],"container-title":["British Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fbjs.4613","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/academic.oup.com\/bjs\/article-pdf\/91\/7\/801\/36730018\/bjs4613.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/bjs\/article-pdf\/91\/7\/801\/36730018\/bjs4613.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,7,9]],"date-time":"2021-07-09T21:20:34Z","timestamp":1625865634000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/bjs\/article\/91\/7\/801\/6143703"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2004,5,10]]},"references-count":132,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2004,5,10]]},"published-print":{"date-parts":[[2004,6,17]]}},"URL":"https:\/\/doi.org\/10.1002\/bjs.4613","relation":{},"ISSN":["0007-1323","1365-2168"],"issn-type":[{"value":"0007-1323","type":"print"},{"value":"1365-2168","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2004,7]]},"published":{"date-parts":[[2004,5,10]]}}}