{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T12:56:20Z","timestamp":1789563380512,"version":"build-2803163510"},"reference-count":32,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2017,3,2]],"date-time":"2017-03-02T00:00:00Z","timestamp":1488412800000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100000297","name":"Royal College of Surgeons of England","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000297","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2017,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Around one\u2010third of patients with Crohn's disease are affected by Crohn's fistula\u2010in\u2010ano (p<jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>). It typically follows a chronic course and patients undergo long\u2010term medical and surgical therapy. We set out to describe current surgical practice in the management of p<jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content> in the <jats:styled-content style=\"fixed-case\">UK<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>A survey of surgical management of <jats:styled-content style=\"fixed-case\">pCD<\/jats:styled-content> was designed by an expert group of colorectal surgeons and gastroenterologists. This assessed acute, elective, multidisciplinary and definitive surgical management. A pilot of the questionnaire was undertaken at the 2015 meeting of the Digestive Disease Federation. The survey was refined and distributed nationally through the trainee collaborative networks.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>National rollout obtained responses from 133 of 179 surgeons approached (response rate 74.3%). At first operation, 32% of surgeons would always consider drainage of sepsis and 31.1% would place a draining seton. At first elective operation, 66.6% would routinely insert of draining seton, and 84.4% would avoid cutting seton. An <jats:styled-content style=\"fixed-case\">IBD<\/jats:styled-content> multidisciplinary team was available to 87.6% of respondents, although only 25.1% routinely discussed <jats:styled-content style=\"fixed-case\">pCD<\/jats:styled-content> patients. Anti\u2010tumour necrosis factor\u2010alpha therapy was routinely considered by 64.2%, although 44.2% left medical management to gastroenterologists. Common definitive procedures were removal of the seton only (70.7%), fistulotomy (57.1%), advancement flap (38.9%), fistula plug (36.4%) and ligation of intersphincteric track (<jats:styled-content style=\"fixed-case\">LIFT<\/jats:styled-content>) procedure (31.8%). Indications for diverting stoma or proctectomy were intractable sepsis, incontinence and poor quality of life.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This survey has demonstrated areas of common practice, but has also highlighted divergent practice including choices of definitive surgery and multimodal management. Practical guidelines are required to support colorectal surgeons in the <jats:styled-content style=\"fixed-case\">UK<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.13462","type":"journal-article","created":{"date-parts":[[2016,7,16]],"date-time":"2016-07-16T14:48:24Z","timestamp":1468680504000},"page":"266-273","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":46,"title":["Surgical management of fistulating perianal Crohn's disease: a UK survey"],"prefix":"10.1111","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9971-1635","authenticated-orcid":false,"given":"M. J.","family":"Lee","sequence":"first","affiliation":[{"name":"Department of General Surgery Sheffield Teaching Hospitals Sheffield UK"},{"name":"Department of Oncology and Metabolism Medical School University of Sheffield Sheffield UK"},{"name":"South Yorkshire Surgical Research Group Department of General Surgery Northern General Hospital Sheffield UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.","family":"Heywood","sequence":"additional","affiliation":[{"name":"University Hospital South Manchester  Manchester UK"},{"name":"North\u2010West Research Collaborative University Hospital South Manchester Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P. M.","family":"Sagar","sequence":"additional","affiliation":[{"name":"St James University Hospital Leeds UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. 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