{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T07:25:59Z","timestamp":1777447559585,"version":"3.51.4"},"reference-count":15,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2020,10,1]],"date-time":"2020-10-01T00:00:00Z","timestamp":1601510400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The American Surgeon\u2122"],"published-print":{"date-parts":[[2020,10]]},"abstract":"<jats:p>Definitive draining seton (DDS) alone is an accepted treatment for complex refractory anal fistulas in Crohn\u2019s disease (CD). We evaluated the long-term success of DDS in CD patients. DDS was defined as draining seton placed definitively for at least 12\u00a0months. Primary end point was clinical response (CR) defined as a lack of induration, pain, swelling, abscess recurrence, or unintended dislodgement. The study cohort of 23 patients had a median age of 29 (range; 9-61) years and included 14 males (61%). Reasons for DDS included anal stenosis (n = 9; 39%), active proctitis (n = 9; 39%), and\/or anal canal ulceration (n = 9; 39%). Median number of setons was 2 (range; 1-6) and 65% had multiple fistula tracts. Almost all patients (n = 22; 96%) were on a biologic postoperatively. At 12-month follow-up, only 39% (n = 9) had a CR. The remaining 14 patients failed due to new abscess formation (n = 6; 26%), new fistula formation (n = 6; 26%), and seton dislodgement (n = 2; 9%). Six (26%) patients required fecal diversion. No patients required proctectomy. DDS for complex CD fistula results in a mediocre CR with many patients developing recurrent abscess\/fistula or requiring diversion despite biologic therapy.<\/jats:p>","DOI":"10.1177\/0003134820964462","type":"journal-article","created":{"date-parts":[[2020,10,20]],"date-time":"2020-10-20T12:34:07Z","timestamp":1603197247000},"page":"1368-1372","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":9,"title":["Outcomes of Definitive Draining Seton Placement for Complex Anal Fistula in Crohn\u2019s Disease"],"prefix":"10.1177","volume":"86","author":[{"given":"Angela","family":"Mujukian","sequence":"first","affiliation":[{"name":"Division of Colon & Rectal Surgery, Cedars Sinai Medical Center, Los Angeles, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karen","family":"Zaghiyan","sequence":"additional","affiliation":[{"name":"Division of Colon & Rectal Surgery, Cedars Sinai Medical Center, Los Angeles, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elliot","family":"Banayan","sequence":"additional","affiliation":[{"name":"Division of Colon & Rectal Surgery, Cedars Sinai Medical Center, Los Angeles, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Phillip","family":"Fleshner","sequence":"additional","affiliation":[{"name":"Division of Colon & Rectal Surgery, Cedars Sinai Medical Center, Los Angeles, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2020,10,20]]},"reference":[{"key":"bibr1-0003134820964462","doi-asserted-by":"publisher","DOI":"10.1097\/DCR.0b013e31823122b3"},{"key":"bibr2-0003134820964462","doi-asserted-by":"publisher","DOI":"10.1007\/DCR.0b013e3181ce8b01"},{"key":"bibr3-0003134820964462","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000000479"},{"key":"bibr4-0003134820964462","doi-asserted-by":"publisher","DOI":"10.1111\/codi.13668"},{"key":"bibr5-0003134820964462","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2017.12.020"},{"key":"bibr6-0003134820964462","unstructured":"World Medical Association. WMA declaration of Helsinki- Ethical principles for medical research involving human subjects. http:\/\/www.wma.net\/en\/30publications\/10policies\/b3\/. Accessed September 30, 2019."},{"key":"bibr7-0003134820964462","doi-asserted-by":"publisher","DOI":"10.1007\/BF00309382"},{"key":"bibr8-0003134820964462","doi-asserted-by":"publisher","DOI":"10.1007\/s005350200153"},{"key":"bibr9-0003134820964462","doi-asserted-by":"publisher","DOI":"10.1097\/00054725-200303000-00003"},{"key":"bibr10-0003134820964462","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.4466"},{"key":"bibr11-0003134820964462","doi-asserted-by":"publisher","DOI":"10.1007\/s10350-004-0830-6"},{"key":"bibr12-0003134820964462","doi-asserted-by":"publisher","DOI":"10.1111\/j.1463-1318.2009.01796.x"},{"key":"bibr13-0003134820964462","doi-asserted-by":"publisher","DOI":"10.1186\/s13063-015-0831-x"},{"key":"bibr14-0003134820964462","doi-asserted-by":"publisher","DOI":"10.1177\/1457496916665763"},{"key":"bibr15-0003134820964462","doi-asserted-by":"publisher","DOI":"10.1111\/codi.13311"}],"container-title":["The American Surgeon\u2122"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0003134820964462","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/0003134820964462","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0003134820964462","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T12:34:49Z","timestamp":1777379689000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/0003134820964462"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,10]]},"references-count":15,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2020,10]]}},"alternative-id":["10.1177\/0003134820964462"],"URL":"https:\/\/doi.org\/10.1177\/0003134820964462","relation":{},"ISSN":["0003-1348","1555-9823"],"issn-type":[{"value":"0003-1348","type":"print"},{"value":"1555-9823","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,10]]}}}