{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T10:17:37Z","timestamp":1771237057559,"version":"3.50.1"},"reference-count":0,"publisher":"Index Copernicus","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pol Przegl Chir"],"published-print":{"date-parts":[[2021,8,31]]},"abstract":"<jats:p>Perianal fistulas in Crohn\u2019s disease (CD) are a major problem. In majority of patient, inflammation involves the rectum.\nPerianal fistulas in CD pose a diagnostic and therapeutic challenge due to severe symptoms and worse prognosis compared\nto cryptogenic fistulas. The accurate diagnosis is crucial for an effective treatment of CD-related perianal fistulas, and the\nfollowing should be determined: anatomy of the fistula, possible strictures and inflammation of the alimentary tract, including\nthe rectum and the anal canal. Treatment of fistulas might be challenging and requires cooperation between the colorectal surgeon and the gastroenterologist. The combination of surgical and pharmacological therapy is more effective than surgical\nor pharmacological therapy alone. In conservative treatment, aminosalicylates or steroids have little significance. In everyday\npractice, antibacterial chemotherapeutics, antibiotics and thiopurines are applied. The most effective are TNF-neutralizing\nantibodies, i.e. infliximab (IFX), adalimumab (ADA) and certolizumab (CER). Surgical management can be urgent including\ndrainage. Elective procedures include dissection of the fistula (simple fistula) or more complex interventions such as mucosal\nflap or ligation of the intersphincteric portion of the fistula. Surgical interventions can be enhanced using the video-assisted\nanal fistula treatment (VAAFT) or negative-pressure therapy. In extreme cases, creation of a stoma may be necessary.\nAlso, tissue glues or so-called plugs may be applied in managing perianal fistulas. The use of stem cells seems promising,\ni.e. application of multipotent non-hematopoietic stem cells around the fistula in order to induce immunomodulation and\nwound healing.\n\n<\/jats:p>","DOI":"10.5604\/01.3001.0015.2335","type":"journal-article","created":{"date-parts":[[2021,9,13]],"date-time":"2021-09-13T12:07:58Z","timestamp":1631534878000},"page":"70-79","source":"Crossref","is-referenced-by-count":3,"title":["Statement of the polish expert group on the current practice and\nprospects for the treatment of complex perianal fistulas in Crohn's\ndisease. Update 2021"],"prefix":"10.5604","volume":"93","author":[{"given":"Tomasz","family":"Banasiewicz","sequence":"first","affiliation":[{"name":"Katedra i Klinika Chirurgii Og\u00f3lnej, Endokrynologicznej i Onkologii Gastroenterologicznej, Uniwersytet Medyczny w Poznaniu"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Piotr","family":"Eder","sequence":"additional","affiliation":[{"name":"Katedra i Klinika Gastroenterologii, Dietetyki i Chor\u00f3b Wewn\u0119trznych, Uniwersytet Medyczny w Poznaniu"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gra\u017cyna","family":"Rydzewska","sequence":"additional","affiliation":[{"name":"Klinika Chor\u00f3b Wewn\u0119trznych i Gastroenterologii z Pododdzia\u0142em Leczenia Nieswoistych Chor\u00f3b Zapalnych Jelit Centralnego, Szpital Kliniczny MSWiA w Warszawie"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jaros\u0142aw","family":"Regu\u0142a","sequence":"additional","affiliation":[{"name":"Klinika Gastroenterologii, Hepatologii i Onkologii Klinicznej, Centrum Medycznego Kszta\u0142cenia Podyplomowego, Centrum Onkologii \u2013 Instytut im. Marii Sk\u0142odowskiej-Curie w Warszawie"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Agnieszka","family":"Dobrowolska","sequence":"additional","affiliation":[{"name":"Katedra i Klinika Gastroenterologii, Dietetyki i Chor\u00f3b Wewn\u0119trznych, Uniwersytet Medyczny w Poznaniu"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marek","family":"Durlik","sequence":"additional","affiliation":[{"name":"Klinika Chirurgii Gastroenterologicznej i Transplantologii, Centralny Szpital Kliniczny MSWiA w Warszawie"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Grzegorz","family":"Wallner","sequence":"additional","affiliation":[{"name":"II Klinika Chirurgii Og\u00f3lnej, Gastroenterologicznej i Nowotwor\u00f3w Uk\u0142adu Pokarmowego, Uniwersytet Medyczny w Lublinie"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adam","family":"Dziki","sequence":"additional","affiliation":[{"name":"Klinika Chirurgii Og\u00f3lnej i Kolorektalnej, Uniwersytet Medyczny w \u0141odzi"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"3689","container-title":["Polish Journal of Surgery"],"original-title":[],"deposited":{"date-parts":[[2021,9,13]],"date-time":"2021-09-13T12:08:58Z","timestamp":1631534938000},"score":1,"resource":{"primary":{"URL":"https:\/\/ppch.pl\/gicid\/01.3001.0015.2335"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8,31]]},"references-count":0,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2021,3,22]]}},"URL":"https:\/\/doi.org\/10.5604\/01.3001.0015.2335","relation":{},"ISSN":["0032-373X","2299-2847"],"issn-type":[{"value":"0032-373X","type":"print"},{"value":"2299-2847","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,8,31]]}}}