Infliximab combined with sphincter-sparing surgery for the treatment of Perianal Crohn′s disease

Abstract

Objective To evaluate the efficacy of infliximab combined with sphincter-sparing surgery in treatment of perianal Crohn′s disease. Methods Clinical data of 49 patients with perianal Crohn′s disease (3 cases with nonfistulizing perianal Crohn′s disease and 46 cases with fistulizing perianal Crohn′s disease) receiving infliximab combined with sphincter-sparing surgery in Jiangsu Province Hospital of TCM from May 2010 to June 2014 were analyzed retrospectively. The situation of fistula closure was assessed. C-reactive protein and perianal disease activity index were estimated by Wilcoxon method. Results No patient was failed to respond to primary treatment. patients (26/46) had a complete response to treatment, 28.3% patients (13/46) had a partial response and 15.2% patients (7/46) had lost response to treatment; 2 cases of anal ulcer healing; No other perianal lesion occurred in 1 case of verrucous skin. At final follow-up, CRP was decreased to[4.5(1.5, 15.9)]mg/L from [16.9(6.6, 35.6)] mg/L(Z=-3.994, P=0.00); PDAI was decreased to[1(0, 4.5)]from [7(4.5, 10.5)] (Z=-6.100, P=0.00). Conclusion Infliximab combined with sphincter-sparing surgery is effective for perianal Crohn′s disease. Key words: Anal canal; Retrospective studies; Surgical procedures, operative; Infliximab; Crohn′s disease