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Surgical Management of Perianal Crohn’s Disease: Current Evidence and Future Directions

Saleh Busbait.




Abstract

Background: Perianal manifestations of Crohn’s disease (CD) are common, with fistulas being the most prevalent and challenging to manage. Objective: The aim of this articles was to describe and explain how Perianal fistulizing Crohn’s disease significantly impacts patients’ quality of life and poses a therapeutic challenge for clinicians. Methods: The author used published papers deposited in index databases PubMed Central, Scopus, HINARY etc. rergarding Surgical Management of Perianal Crohn’s Disease: Current Management requires a multidisciplinary and multimodal approach, integrating both medical and surgical interventions tailored to disease severity and fistula complexity. Results and Discussion: Despite advancements in therapy, the majority of patients require multiple interventions due to high rates of primary non-healing, surgical morbidity, and recurrence..Medical treatment primarily includes biologics, particularly anti-TNF agents such as infliximab and adalimumab, which have demonstrated efficacy in fistula closure and symptom control. Surgical approaches remain critical with various degrees of success. Conclusion: Despite the availability of multiple therapeutic options, Perianal fistulizing Crohn’s disease remains a complex condition with ongoing challenges in achieving sustained remission. Future research should focus on novel treatment strategies and optimizing individualized patient care.

Key words: Crohn’s disease, Perianal Crohn’s disease, Perianal fistula, medical and surgical management.





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