{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T08:33:57Z","timestamp":1740126837307,"version":"3.37.3"},"reference-count":18,"publisher":"Georg Thieme Verlag KG","issue":"03","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Zentralbl Chir"],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title><jats:p>\n            Hintergrund Die chirurgische Behandlung von perianalen Fisteln, die von Morbus Crohn (MC) oder kryptoglandul\u00e4ren Abszessen (KGA) ausgehen, bleibt eine Herausforderung. Daten zu\n            langfristigen Heilungsraten sind rar. Unser Ziel war es, die langfristige Erfolgsrate von Mukosa-Muskel-Flap-Operationen (MMF-Operationen) zu bewerten.<\/jats:p><jats:p>\n            Methoden Diese monozentrische retrospektive Studie wurde zwischen dem 1. M\u00e4rz 2010 und dem 31. M\u00e4rz 2020 an einem terti\u00e4ren Referenzzentrum (Charit\u00e9 Universit\u00e4tsklinikum Berlin,\n            Campus Benjamin Franklin) durchgef\u00fchrt. Patienten mit komplexen perianalen Fisteln, die durch MC oder KGA entstanden und mit MMF behandelt wurden, wurden eingeschlossen. Die langfristigen\n            Heilungsraten von MMF-Operationen bei KGA und MC wurden verglichen. Regressionsanalysen wurde angewandt, um pr\u00e4diktive Faktoren f\u00fcr eine definitive Heilung zu identifizieren.<\/jats:p><jats:p>\n            Ergebnisse 83 Patienten (24 MC, 59 KGA) wurden eingeschlossen. Die mediane Nachbeobachtungszeit betrug bei MC 5,4 und bei KGA 1,9 Jahre. Eine definitive Heilung der Fisteln wurde\n            bei 19 (79,2%) MC-Patienten (p\u00a0=\u00a00,682) und bei 44 (74,6%) KGA-Patienten erreicht. Die Heilungszeit war bei KGA signifikant k\u00fcrzer als bei MC (9,3 Monate [Standardabweichung: SD =\u00a011,3\n            Monate] vs. 30,9 Monate [SD =\u00a023,5 Monate]; p\u00a0&lt;\u00a00,001). Die Behandlung mit Biologika (Hazard Ratio: HR =\u00a00,18; 95%-Konfidenzintervall: 95%-KI =\u00a00,06\u20130,59; p\u00a0=\u00a00,004) und die Anlage\n            eines protektiven Ileostomas (HR =\u00a00,29; 95%-KI =\u00a00,10\u20130,85; p\u00a0=\u00a00,023) bei MC waren unabh\u00e4ngige Pr\u00e4diktoren f\u00fcr den MMF-Erfolg. Die gleichzeitige Medikation mit Azathioprin bei MC war ein\n            unabh\u00e4ngiger Pr\u00e4diktor f\u00fcr MMF-Versagen (HR =\u00a03,20; 95%-KI =\u00a01,05\u20139,81; p\u00a0=\u00a00,041).<\/jats:p><jats:p>\n            Schlussfolgerung Diese Studie zeigt, dass die chirurgische Therapie von perianalen Fisteln mit MMF bei insgesamt etwa 75% der Patienten erfolgreich ist. Patienten mit MC\n            profitieren von Biologika und einem protektiven Ileostoma. Die Behandlung mit Azathioprin hat einen negativen Einfluss auf die Rezidivrate. Eine vorangegangene MMF-Operation erh\u00f6ht das\n            Risiko eines MMF-Versagens bei wiederholten Operationen nicht.<\/jats:p>","DOI":"10.1055\/a-2039-2896","type":"journal-article","created":{"date-parts":[[2023,3,17]],"date-time":"2023-03-17T00:02:40Z","timestamp":1679011360000},"page":"259-266","source":"Crossref","is-referenced-by-count":0,"title":["Effektivit\u00e4t von Mukosa Muskel Flaps in der Behandlung von perianalen Fisteln bei Morbus Crohn und kryptoglandul\u00e4ren Fisteln \u2013 eine Langzeit-Follow-up-Studie"],"prefix":"10.1055","volume":"148","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9189-6751","authenticated-orcid":false,"given":"Christian","family":"Schineis","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Allgemein- und Viszeralchirurgie, Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, Campus Benjamin Franklin, Berlin, 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