{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T04:28:03Z","timestamp":1791520083040,"version":"4.3.4"},"reference-count":23,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2020,7,31]],"date-time":"2020-07-31T00:00:00Z","timestamp":1596153600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100013236","name":"MSD Life Science Foundation, Public Interest Incorporated Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100013236","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008373","name":"Takeda Pharmaceutical Company","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008373","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>The medico\u2010surgical strategy for the treatment of perianal fistulizing Crohn's disease (CD) following surgical drainage remains challenging and debated. Our aims were to describe the failure rate of therapeutic interventions after drainage of the fistula tract and determine the factors associated with failure to optimize medico\u2010surgical strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>All consecutive patients with perianal fistulizing CD who underwent surgical drainage with at least a 12\u2010week follow\u2010up were included. Failure was defined as the occurrence of at least one of the following items: abscess recurrence, purulent discharge from the tract, visible external opening and further drainage procedure(s).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      One hundred and sixty\u2010nine patients were included. The median follow\u2010up was 4.0\u00a0years. The cumulative failure rates were 20%, 30% and 36% at 1, 3 and 5\u00a0years, respectively. The cumulative failure rates in patients who had sphincter\u2010sparing surgeries or seton removal were significantly higher than in those who had a fistulotomy. Anterior fistula [hazard ratio (HR)\u00a0=\u00a02.52 (1.13\u20135.61),\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.024], supralevator extension [HR\u00a0=\u00a020.78 (3.38\u2013127.80),\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.001] and the absence or discontinuation of immunosuppressants after anal drainage [HR\u00a0=\u00a03.74 (1.11\u201312.5),\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.032] were significantly associated with failure in the multivariate analysis model.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Combined strategies for perianal fistulizing CD lead to a failure rate of 36% at 5\u00a0years. Where advisable, fistulotomy may be preferred because it has a lower rate of recurrence. The benefits of immunosuppressants require a dedicated prospective randomized trial.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/codi.15241","type":"journal-article","created":{"date-parts":[[2020,7,8]],"date-time":"2020-07-08T16:48:27Z","timestamp":1594226907000},"page":"159-168","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Combined strategies following surgical drainage for perianal fistulizing Crohn's disease: failure rates and prognostic factors"],"prefix":"10.1111","volume":"23","author":[{"given":"A.","family":"Herissay","sequence":"first","affiliation":[{"name":"CHU Rennes Universitaire Rennes Rennes France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Siproudhis","sequence":"additional","affiliation":[{"name":"INSERM CIC1414 Institut NUMECAN (Nutrition Metabolism and Cancer) CHU Rennes Universitaire Rennes Rennes 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