Application and efficacy of intestinal repair in Crohn′s disease complicated with intestinal internal fistula in different locations

Abstract

Objective To investigate the application and efficacy of intestinal repair in different intestinal segments for fistulizing Crohn′s disease (CD). Methods Clinical data of CD patients complicated with enteroenteric fistula undergoing primary lesion intestine resection and intestinal repair (the victim segment was free from CD) at Inflammatory Bowel Disease Center, Jinling Hospital from January 2011 to August 2016 were retrospectively analyzed. Patients were grouped according to the location of repair: duodenum (25 cases), small intestine (19 cases), and sigmoid colon (21 cases). The postoperative complications and relapse were summarized. Results Sixty-five patients were eligible for the study. Fistula was diagnosed preoperatively in 49 patients (75.4%), while those were found intra-operatively in 16 patients (24.6%). Among 65 patients, postoperative complications developed in 19 cases, including wound infection in 12 cases, leakage at the repair site in 1 case, anastomotic leakage in 1 case, and intra-abdominal abscess in 5 cases. During the follow-up of mean (19.4±16.5) months, no recurrence or new lesion of CD and no stenosis at the repair site were noted in 62 patients whose repair location was accessible in endoscopy examination. No significant difference was found in terms of postoperative complication and relapse among these 3 groups. Conclusions Primary repair in the intestinal segments without lesion for fistulizing CD not only develops rare leakage at repair site, but also does not result in recurrence or new lesion of CD and stenosis at the repair site. Location of the repair has no influence on the efficacy. Key words: Crohn′s disease; Intestinal fistula; Intestinal repair