Management of Anal Fistulas in Crohn's Disease: a Surgical Perspective

: Anal conditions caused by gastrointestinal Crohn's disease may be difficult management problems. Recent application of more aggressive surgical treatment of fistulas has challenged the traditional surgical dictum of avoiding anal surgery in patients with underlying Crohn's disease. Judicious patient selection combined with conservative and creative operative techniques may be expected to result in healing in the majority of patients, preventing the need for proctectomy while preserving satisfactory sphincter function.