{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T19:36:47Z","timestamp":1790624207700,"version":"4.1.0"},"reference-count":115,"publisher":"Korean Society of Coloproctology","issue":"1","license":[{"start":{"date-parts":[[2021,2,28]],"date-time":"2021-02-28T00:00:00Z","timestamp":1614470400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["coloproctol.org"],"crossmark-restriction":true},"short-container-title":["Ann Coloproctol"],"published-print":{"date-parts":[[2021,2,28]]},"abstract":"<jats:p>Perianal fistula is a frequent complication and one of the subclassifications of Crohn disease (CD). It is the most commonly observed symptomatic condition by colorectal surgeons. Accurately classifying a perianal fistula is the initial step in its management in CD patients. Surgical management is selected based on the type of perianal fistula and the presence of rectal inflammation; it includes fistulotomy, fistulectomy, seton procedure, fistula plug insertion, video-assisted ablation of the fistulous tract, stem cell therapy, and proctectomy with stoma creation. Perianal fistulas are also managed medically, such as antibiotics, immunomodulators, and biologics including anti-tumor necrosis factor-alpha agents. The current standard treatment of choice for perianal fistula in CD patients is the multidisciplinary approach combining surgical and medical management; however, the rate of long-term remission is low and is reported to be 50% at most. Therefore, the optimum management strategy for perianal fistulas associated with CD remains controversial. Currently, the goal of management for CD-related perianal fistulas are controlling symptoms and maintaining long-term anal function without proctectomy, while monitoring progression to anorectal carcinoma. This review evaluates perianal fistula in CD patients and determines the optimal surgical management strategy based on recent evidence.<\/jats:p>","DOI":"10.3393\/ac.2021.02.08","type":"journal-article","created":{"date-parts":[[2021,3,8]],"date-time":"2021-03-08T00:54:01Z","timestamp":1615164841000},"page":"5-15","update-policy":"https:\/\/doi.org\/10.3393\/crossmark_policy","source":"Crossref","is-referenced-by-count":30,"title":["Treatment Strategy for Perianal Fistulas in Crohn Disease Patients: The Surgeon\u2019s Point of View"],"prefix":"10.3393","volume":"37","author":[{"given":"Jong Lyul","family":"Lee","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong Sik","family":"Yoon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9401-9981","authenticated-orcid":true,"given":"Chang Sik","family":"Yu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1975","reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1093\/ecco-jcc\/jjv228"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1053\/gast.2002.32362"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1038\/nrgastro.2017.104"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1093\/ibd\/izy329"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1007\/s12325-019-01117-y"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.5217\/ir.2014.12.3.173"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1093\/ecco-jcc\/jjv003"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2005.082909"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1136\/gut.49.6.777"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2017-314918"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2013-306709"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1111\/apt.12906"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1056\/nejmoa0904492"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1007\/s10151-010-0607-y"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.1800630102"},{"key":"ref16","first-page":"1508","volume-title":"American Gastroenterological Association Clinical Practice Committee. 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