{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T15:19:53Z","timestamp":1781882393823,"version":"3.54.5"},"reference-count":32,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2021,10,23]],"date-time":"2021-10-23T00:00:00Z","timestamp":1634947200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100006483","name":"AbbVie","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006483","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>In patients with fistulizing perianal Crohn's disease (CD), the need for a secondary surgical step is not defined. The aim was to assess the efficacy of surgical closure compared to a single seton removal in patients with drained fistulizing perianal CD treated with adalimumab.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a multicentre, randomized controlled trial, comparing seton removal\u00a0+\u00a0surgical closure (closure group) to seton removal alone (control group) with a stratification according to the American Gastroenterological Association classification. The primary end\u2010point was fistula closure at month 12 defined by the association of the following criteria: no seton, absence of a visible external opening, absence of discharge from the tract after finger compression, absence of an internal opening, absence of perianal pain\/abscess and absence of fistula\u2010related abnormalities.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among the 64 included patients (262 expected) (48 complex fistula, 75%), 33 were randomized to the closure group and 31 to the control group. In the closure group, 26 patients (78.8%) had glue. At month 12, overall fistula closure was achieved in 35 of the evaluable 58 patients (60%): 18\/32 (56%) in the surgery group and 17\/26 (65%) in the control group (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.479). In the closure group, fistula closure was observed in 13\/25 (52%) and 5\/7 (71%) patients with complex and simple fistula respectively (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.426), compared with 12\/18 (67%) and 5\/8 (63%), respectively in the control group (<jats:italic>P<\/jats:italic>\u00a0=\u00a01.000).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Seton removal alone seems to be no more effective than a secondary surgical step (in particular glue injection) in patients having fistulizing perianal CD controlled by an initial drainage combined with adalimumab. The results should be interpreted with caution.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.15947","type":"journal-article","created":{"date-parts":[[2021,10,9]],"date-time":"2021-10-09T08:56:24Z","timestamp":1633769784000},"page":"210-219","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Surgical closure, mainly with glue injection and anti\u2010tumour necrosis factor \u03b1, in fistulizing perianal Crohn's disease: A multicentre randomized controlled trial"],"prefix":"10.1111","volume":"24","author":[{"given":"Laurent","family":"Abramowitz","sequence":"first","affiliation":[{"name":"Service d\u2019H\u00e9pato\u2010gastroent\u00e9rologie et Proctologie H\u00f4pital Bichat\u2010Claude Bernard  Paris France"},{"name":"Ramsay G\u00e9n\u00e9ral de Sant\u00e9 Clinique Blomet  Paris 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