Abstract:
BACKGROUND:Perianal fistulising Crohn's disease (PFCD) affects a third of Crohn's disease patients and represents a disabling phenotype with poor outcome. The anti-tumour necrosis factor alpha (TNF) therapies have been shown to maintain clinical remission in a third of patients after 1 year of treatment. Maintenance therapy with systematic administration schedules confers greatest benefit, but exposes patients to risks/side effects of continued systemic use and led to consideration of local drug delivery (first described in 2000). In this review, we analyse all published articles on local anti-TNF therapy in the treatment of PFCD. METHODS:The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used to systematically search Medline and Embase using the medical subject headings 'fistula', 'anus', 'Crohn disease', 'infliximab' and 'adalimumab'. This was combined with free text searches, e.g. 'local injection' and 'Crohn's perianal disease'. Studies/abstracts describing local injection treatment with anti-TNF were included in this review. RESULTS:Six pilot studies including a total of 92 patients were included in this review. Outcomes reported were mostly clinical and included 'complete/partial response' to therapy and short-term results varied between 40 and 100%. There were no significant adverse events and the local injections were well tolerated. CONCLUSIONS:There is paucity of data assessing this treatment modality. Local anti-TNF therapy appears safe, but outcome reporting is heterogeneous, subjective and long-term data are unavailable. Our review suggests a potential role may be in those in whom systemic treatment is contraindicated and calls for standardised reporting of outcomes in this field to enable better data interpretation.
journal_name
Int J Colorectal Disjournal_title
International journal of colorectal diseaseauthors
Adegbola SO,Sahnan K,Tozer PJ,Phillips RK,Faiz OD,Warusavitarne J,Hart Adoi
10.1007/s00384-017-2899-0subject
Has Abstractpub_date
2017-11-01 00:00:00pages
1539-1544issue
11eissn
0179-1958issn
1432-1262pii
10.1007/s00384-017-2899-0journal_volume
32pub_type
杂志文章,评审abstract:BACKGROUND AND AIMS:Anal abscess is a frequent acute proctological disorder and whether the underlying fistula should be treated at the same time when the abscess is drained remains controversial. We examined indications for drainage alone versus drainage plus fistulotomy in terms of recurrence and continence. PATIENT...
journal_title:International journal of colorectal disease
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1007/s00384-002-0429-0
更新日期:2003-03-01 00:00:00
abstract:INTRODUCTION:When severe chronic pelvic pain, constipation, and bloating are due to dense pelvic adhesions fixing the sigmoid loops, patients may be offered the option of sigmoid colectomy. This study examines the effectiveness of colectomy in the treatment of such patients. METHODS:Patients were identified from a sur...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-013-1711-z
更新日期:2013-10-01 00:00:00
abstract::Disruption of the anal sphincter results from obstetric injury, ano-rectal operations or external trauma. Obstetric or surgical division of the sphincteric mechanism may not be immediately apparent and the clinical presentation of incontinence may occur several years later [1, 2]. Reconstruction of the sphincter using...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/BF00699424
更新日期:1994-05-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Whether race affects the natural history of Crohn's disease is a matter of debate. The aim of the current study was to evaluate the differences in surgical outcomes between African-American (AA) and Caucasian (C) Crohn's patients undergoing surgery at a tertiary care referral center. METHODS:W...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-014-1902-2
更新日期:2014-08-01 00:00:00
abstract:BACKGROUND:The clinicopathological roles and relationships of hTERT, p21 and p53 proteins have not been studied in depth in colorectal cancer. The aim of the present study is to investigate the clinicopathological roles of expression of hTERT protein expression and its relationship with the expression of p21 and p53 pr...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-008-0455-7
更新日期:2008-06-01 00:00:00
abstract:AIM:The aim of this experimental study was to investigate the effect of intraperitoneal administration of oxaliplatin on the healing of colonic anastomoses when injected immediately after colon resection. MATERIALS AND METHODS:Thirty male Wistar rats were used. During the operation, the rats were randomized to two gro...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-008-0538-5
更新日期:2008-12-01 00:00:00
abstract::A retrospective study of 87 patients, subjected to colostomy closure between 1976 and 1987, was conducted in order to evaluate the role of 8 potential risk factors on morbidity and mortality. Possible risk factors were age greater than 65 years, presence of hypoalbuminaemia (less than 3.0 gr%), anaemia (Hb less than 1...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/BF00298472
更新日期:1990-05-01 00:00:00
abstract:BACKGROUND:The appearance of a carcinoma in the ileal pouch after restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) for ulcerative proctocolitis is rare. Most of these adenocarcinomas previously described in literature develop from residual viable rectal mucosa. We report a case of an adenocarcinoma ...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-005-0063-8
更新日期:2006-07-01 00:00:00
abstract:PURPOSE:The treatment of acutely obstructed carcinoma of the left colon still represents a matter of controversy. The aim of the study was to evaluate the results of its management by emergency subtotal or total colectomy with immediate anastomosis without diversion. METHODS:An emergency subtotal/total colectomy was p...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-005-0048-7
更新日期:2006-09-01 00:00:00
abstract:BACKGROUND:MRI detected extramural vascular invasion (mrEMVI) is a poor prognostic factor in rectal cancer patients. The objectives of this study were to assess survival outcomes in patients with and without mrEMVI and to compare the prognostic value of mrEMVI with other rectal cancer features. METHODS:In a Dutch high...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-020-03632-9
更新日期:2020-10-01 00:00:00
abstract:PURPOSE:Persistent fecal incontinence beyond childhood is common in ARM patients. The aim of this study was to analyze a consecutive series of adult patients with persistent incontinence, establish the causes, and evaluate whether further treatment could be offered. METHODS:Forty-four adult ARM patients with reported ...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-018-3220-6
更新日期:2019-03-01 00:00:00
abstract::We have been using endoluminal ultrasonography since 1988 as part of the follow-up procedure after colorectal surgery. A total of 106 patients with anterior resection of the rectum or the sigmoid colon were involved in 1988. The follow-up period for these patients ranged from 1 to 56 months after surgery (23.1 +/- 15....
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/BF00303273
更新日期:1990-12-01 00:00:00
abstract:PURPOSE:The purpose of this study was to prospectively compare rectal resection (RR) with colonic resection on sexual, urinary and bowel function and quality of life in both short-term and long-term. METHODS:Eighty-three patients who underwent RR were compared to 53 patients who underwent a colonic resection leaving t...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-011-1288-3
更新日期:2011-12-01 00:00:00
abstract::The mechanisms of the antineoplastic effect of nonsteroidal anti-inflammatory drugs (NSAIDs) still are unknown, but the induction of apoptosis is one of the possible mechanisms. We attempted to demonstrate the role of mitogen-activated protein (MAP) kinases, generally considered to be important mediators of proliferat...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s003840100301
更新日期:2001-06-01 00:00:00
abstract:BACKGROUND AND AIMS:Ulcerative colitis is an established risk factor for colorectal cancer but dysplasia reports are much more frequent than invasive neoplasm diagnosis. The effective activation of T lymphocytes that provide antitumor surveillance requires the presence of costimulation molecules such as CD80 and CD86 o...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-006-0095-8
更新日期:2006-12-01 00:00:00
abstract:PURPOSE:This study aims to evaluate pubovisceral muscle and anal sphincter defects in women with previous vaginal delivery and fecal incontinence and to correlate the findings with the severity of symptoms using the combined anorectal and endovaginal 3D ultrasonography with a new ultrasound scoring system. METHODS:Con...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-016-2750-z
更新日期:2017-04-01 00:00:00
abstract:PURPOSE:We evaluated the efficacy of oral administration of a mixture of diosmin, coumarin glycosides, and Centella asiatica (Venoplant®) in preventing bleeding, pain, and thrombosis of internal and external hemorrhoids after stapled anopexy (SA). METHODS:SA was conducted in 182 patients with third-degree hemorrhoids....
journal_title:International journal of colorectal disease
pub_type: 杂志文章,随机对照试验
doi:10.1007/s00384-016-2698-z
更新日期:2017-03-01 00:00:00
abstract:PURPOSE:Circulating tumor cells (CTCs) represent an independent prognostic factor in metastatic colorectal cancer, while their significance in early stages is still an open issue. The aim of the study is to investigate the role of CTCs in rectal cancer patients undergoing neoadjuvant chemoradiotherapy (CT-RT). METHODS...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-014-1958-z
更新日期:2014-09-01 00:00:00
abstract:OBJECTIVE:The objective of this study is to identify rates and factors associated with permanent diversion following restorative proctosigmoidectomy for rectal cancer when complicated by an anastomotic leak. DESIGN:This study is a retrospective review. SETTING:The setting of this study is a tertiary referral hospital...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-012-1423-9
更新日期:2012-10-01 00:00:00
abstract:BACKGROUND:Genetic variability in obesity-related genes and the resulting phenotypes are being recognized as major risk factors for colorectal cancer and/or severity of the disease. MATERIALS AND METHODS:A total of 102 patients (aged 68 +/- 10.2 years, 79 men and 23 women) and 101 age-matched (68.1 +/- 5.4 years old) ...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-008-0553-6
更新日期:2009-03-01 00:00:00
abstract:PURPOSE:This study evaluates the erectile function of male patients treated by preoperative radiotherapy followed by surgery and surgery alone for locally advanced rectal cancer. METHODS:A total of 112 men treated by total mesorectal excision with autonomic nerve preservation were included. Seventy-three patients were...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-010-0879-8
更新日期:2010-05-01 00:00:00
abstract:OBJECTIVE:For colorectal screening patients a mean gain of life time was previously calculated of about 30-50 days. Different recommendations for recognising at-risk groups and defining surveillance intervals after an initial finding of colorectal adenomas have been published. However, no benefit-risk analysis regardin...
journal_title:International journal of colorectal disease
pub_type: 杂志文章,meta分析
doi:10.1007/s00384-006-0252-0
更新日期:2007-08-01 00:00:00
abstract:PURPOSE:The RET protooncogene plays a crucial role in neural crest development; accordingly, mutations of RET cause MEN2A and familial medullary thyroid carcinoma, while the expression deregulation of RET is involved in the pathophysiology of glioblastoma multiforme (GBM) and pancreatic cancer (PDAC). The aim of this s...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-011-1150-7
更新日期:2011-07-01 00:00:00
abstract:PURPOSE:The purpose of this study was to investigate the possible association between tumor necrosis factor-α (TNF-α) levels and defects in the activated protein C (APC) system as a determinant of venous thromboembolism (VTE) in metastatic colorectal cancer patients (mCRC) undergoing chemotherapy. METHODS:TNF-α levels...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-012-1493-8
更新日期:2012-12-01 00:00:00
abstract:PURPOSE:Extra-levator abdominoperineal excision for rectal cancer includes resection of the levator ani muscle and therefore makes pelvic reconstruction advisable. The aim of our study was to evaluate morphologic and functional long-term results of pelvic floor augmentation with porcine dermal collagen mesh by dynamic ...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-015-2169-y
更新日期:2015-04-01 00:00:00
abstract::We investigated sinusoidal blood flow and hepatic tissue oxygenation during portal vein occlusion in cirrhotic rat livers to examine the effect of cirrhosis on the properties of hepatic microvascular blood flow regulation. After 8 weeks of CCl4/phenobarbital sodium treatment to induce cirrhosis Sprague-Dawley rats wer...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s003840000247
更新日期:2000-11-01 00:00:00
abstract:PURPOSE:There is scant data assessing the consequences of staging restorative proctocolectomy for ulcerative colitis. The aim of the study is to compare outcomes of initial vs. staged restorative proctocolectomy. METHODS:Patients completing restorative proctocolectomy, including ileostomy reversal, during 2006-2012 we...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-017-2836-2
更新日期:2017-08-01 00:00:00
abstract:PURPOSE:Rectal advancement flap is an accepted approach for treating complex fistula-in-ano. However, a diversity of technical modifications have been described. The aim of this study was to evaluate recurrence and fecal continence rates after performing rectal advancement flaps depending upon flap thickness (full-thic...
journal_title:International journal of colorectal disease
pub_type: 杂志文章,meta分析,评审
doi:10.1007/s00384-017-2779-7
更新日期:2017-05-01 00:00:00
abstract:INTRODUCTION:Prior international datasets have demonstrated equivocal results in the rate of surgical procedures for the treatment of Crohn's disease (CD) following the introduction of biologic medications. The first biologic medication licensed for use in the Republic of Ireland (ROI) was infliximab in 1999. The curre...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-013-1698-5
更新日期:2013-10-01 00:00:00
abstract:PURPOSE:Improved survival in patients with stage III colon cancer after a laparoscopic colectomy (LC) has been reported by Lacy et al. (Lancet 359:2224-2229, 6), and preserved immunity was suggested as the reason for the survival advantage. The aim of our study was to clarify the existence of an immunological benefit a...
journal_title:International journal of colorectal disease
pub_type: 临床试验,杂志文章
doi:10.1007/s00384-010-0882-0
更新日期:2010-05-01 00:00:00