{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T07:29:35Z","timestamp":1790839775640,"version":"4.1.0"},"reference-count":20,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2018,10,10]],"date-time":"2018-10-10T00:00:00Z","timestamp":1539129600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2019,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Rectal flap advancement is still a part of therapeutic management of anal fistulas. Data on the outcome of rectal flap advancement in patients with Crohn's disease (CD) is scarce. Our objective was to ascertain rates of failure of rectal flap advancement and to determine predictive factors for failure, with a special focus on CD<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>The patients\u2019 details, the characteristics of the fistula and the main clinical and therapeutic events were prospectively assessed among patients who underwent rectal flap advancement. All patients had a partial\u2010thickness rectal flap advancement. Failure of primary rectal flap advancement was defined as the occurrence of at least one of the following: abscess, discharge, visible external opening, further drainage procedure. The rates of failure of rectal flap and the predictive factors of failure were assessed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Eighty\u2010seven patients (34 patients with CD) were included. The median (interquartile range) follow\u2010up was 13.3 (3.8\u201338.1) months. The cumulative failure rates were 15.9% (10.3\u201323.6), 23.0% (16.0\u201331.8), 31.6% (22.9\u201341.8) and 41.3% (30.5\u201353.0) at 3, 6, 12 and 24\u00a0months respectively. These data were comparable in Crohn's patients. Those with a supralevator fistula [hazard ratio\u00a02.53 (1.01\u20137.71), <jats:italic>P<\/jats:italic>\u00a0=\u00a00.0476] and patients who had fewer than two fistula drainages before rectal flap [hazard ratio\u00a03.19 (1.40\u20138.23), <jats:italic>P<\/jats:italic>\u00a0=\u00a00.005] were associated with higher rectal flap failure rates. In CD patients, the absence of biological therapy at referral was predictive of failure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Rectal flap advancement is a satisfactory option for the therapeutic management of anal fistula, including CD populations. Fistula drainage is needed before performing this surgical technique.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.14417","type":"journal-article","created":{"date-parts":[[2018,9,10]],"date-time":"2018-09-10T17:58:34Z","timestamp":1536602314000},"page":"66-72","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Advancement flap procedure in Crohn and non\u2010Crohn perineal fistulas: a simple surgical approach"],"prefix":"10.1111","volume":"21","author":[{"given":"G.","family":"Bessi","sequence":"first","affiliation":[{"name":"Department of Gastroenterology University Hospital of Rennes Pontchaillou France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Siproudhis","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology University Hospital of Rennes Pontchaillou France"},{"name":"INSERM U1241 University of Rennes 1 Rennes France"},{"name":"INPHY CIC 1414 University 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