{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T04:28:02Z","timestamp":1791520082654,"version":"4.3.4"},"reference-count":28,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T00:00:00Z","timestamp":1778544000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T00:00:00Z","timestamp":1778544000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100003252","name":"Lund University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100003252","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Tech Coloproctol"],"published-print":{"date-parts":[[2026,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Fistulizing perianal Crohn\u2019s disease is complex and negatively affects quality of life. Rectal advancement flap (AF) has been widely adopted as a sphincter-preserving procedure for treating complex anal fistulas. The European Crohn\u2019s and Colitis Organisation (ECCO) guidelines on surgical treatment of Crohn\u2019s disease state that AF is a therapeutic option for patients with Crohn\u2019s disease and complex perianal fistulas. Despite its use in clinical practice, documented use of AF in treating fistulas related to Crohn\u2019s disease remains limited. This narrative review aimed to examine the latest literature and discuss current evidence for the surgical treatment of fistulizing perianal Crohn\u2019s disease using AF procedures. A PICO search was conducted in the electronic databases PubMed, Embase, and Google Scholar to identify studies published in English on the topic between 2018 and November 2025. In total, 11 studies were identified, including 305 patients with Crohn\u2019s disease. Most patients received a draining loose seton prior to the AF procedure, while the proportion of patients on biological therapy or with a diverting stoma varied greatly. Reported success rates for clinical healing ranged from 23% to 91%, with median follow-up times reported between 7\u00a0months and 6\u00a0years (total range: 2\u00a0months to 10\u00a0years). Despite the inherent limitations of mostly retrospective and small studies, the available evidence supports the feasibility of AFs in fistulizing perianal Crohn\u2019s disease, provided there is adequate fistula drainage and, importantly, optimized biological therapy to minimize luminal and perianal inflammation.<\/jats:p>","DOI":"10.1007\/s10151-026-03325-5","type":"journal-article","created":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T18:55:02Z","timestamp":1778612102000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Advancement flaps in perianal fistulizing Crohn\u2019s disease: technical steps and current evidence"],"prefix":"10.1007","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6960-7490","authenticated-orcid":false,"given":"U.","family":"Aho F\u00e4lt","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7518-9213","authenticated-orcid":false,"given":"P.","family":"Myrelid","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,12]]},"reference":[{"key":"3325_CR1","doi-asserted-by":"publisher","first-page":"349","DOI":"10.1080\/00365521.2025.2476669","volume":"60","author":"AH Everhov","year":"2025","unstructured":"Everhov AH, Eberhardson M, Soderling J, Nordenvall C, Halfvarson J, Ludvigsson JF, Olen O, Myrelid P, Strid H, Hjortswang H, Olsson M, Bengtsson JL, Andersson MA, Karling P, Rejler M, Jaghult S, Fagerberg UL, Marild K, Hreinsson J, Hedin C, SS Group (2025) Cumulative incidence and prevalence of perianal diseases in patients with inflammatory bowel disease and in the population: a nationwide Swedish study. 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