Al-Maawali AKS1, Nguyen P2 and Phang PT1*
1Department of Surgery, St Paul’s Hospital, Canada
2Department of Surgery, University of British Columbia, Canada
Crohn’s disease (CD) is a complex disorder with important incidence in North America. Perianal fistulas occur in about 20% of patients with CD and are almost always classified as complex fistulas. Conventional treatment options have shown different success rates, yet there are data indicating that these approaches cannot achieve total cure and may not improve quality of life of these patients. Fibrin glue, fistula plug, topical tacrolimus, local injection of infliximab and use of hematopoietic stem cells (HSC) and mesenchymal stem cells (MSC) are newly suggested therapies with variable success rates. Here, we aim to review these novel therapies for the treatment of complex fistulizing CD. Although initial results are promising, randomized studies are needed to prove efficacy of these approaches in curing fistulizing perianal CD.
Crohn’s disease; Perianal fistula; Fibrin glue; Fistula plug; Infliximab; Stem cell therapy
Al-Maawali AKS, Nguyen P, Phang PT. Modern Treatments and Stem Cell Therapies for Perianal Crohn's Fistulas. Clin Surg. 2016; 1: 1214.