Annals of Coloproctology

Original Article

Clinical Characteristics and Incidence of Perianal Diseases in Patients With Ulcerative Colitis: Yong Sung Choi, Do Sun Kim, Doo Han Lee, Jae Bum Lee, Eun Jung Lee, Seong Dae Lee, Kee Ho Song, Hyung Joong Jung; Ann Coloproctol. 2018;34(3):138-143. Published online June 30, 2018; DOI: https://doi.org/10.3393/ac.2017.06.08

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Purpose
While perianal disease (PAD) is a characteristic of patients with Crohn disease, it has been overlooked in patients with ulcerative colitis (UC). Thus, our study aimed to analyze the incidence and the clinical features of PAD in patients with UC.
Methods
We reviewed the data on 944 patients with an initial diagnosis of UC from October 2003 to October 2015. PAD was categorized as hemorrhoids, anal fissures, abscesses, and fistulae after anoscopic examination by experienced proctologists. Data on patients’ demographics, incidence and types of PAD, medications, surgical therapies, and clinical course were analyzed.
Results
The median follow-up period was 58 months (range, 12–142 months). Of the 944 UC patients, the cumulative incidence rates of PAD were 8.1% and 16.0% at 5 and 10 years, respectively. The incidence rates of bleeding hemorrhoids, anal fissures, abscesses, and fistulae at 10 years were 6.7%, 5.3%, 2.6%, and 3.4%, respectively. The cumulative incidence rates of perianal sepsis (abscess or fistula) were 2.2% and 4.5% at 5 and 10 years, respectively. In the multivariate analyses, male sex (risk ratio [RR], 4.6; 95% confidence interval [CI], 1.7–12.5) and extensive disease (RR, 4.2; 95% CI, 1.6–10.9) were significantly associated with the development of perianal sepsis.
Conclusion
Although the clinical course of PAD in patients with UC is not serious, in clinical practice, PAD is not rare in such patients. Therefore, careful examination and appropriate management for PAD is needed if the quality of life for patients with UC is to be improved.

Citations

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Uchenna E Okpete, Haewon Byeon
World Journal of Clinical Cases.2025;[Epub] CrossRef
The bacterial composition signatures of perianal abscess and origin of infecting microbes
Song Han, Wenya Su, Kefeng Fan, Zhen Xu, Hai Xu, Mingyu Wang, Ling Li, Wenlong Shen
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Case Report

Persistent Bleeding Following a Stapled Hemorrhoidopexy: Seong Dae Lee, Sung Taek Jung, Jae-Bum Lee, Mi Jung Kim, Doo-Seok Lee, Eui-Gon Youk, Do-Sun Kim, Doo-Han Lee; Ann Coloproctol. 2016;32(3):120-122. Published online June 30, 2016; DOI: https://doi.org/10.3393/ac.2016.32.3.120

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40 Download
1 Web of Science
1 Citations

Abstract PDF

A stapled hemorrhoidopexy (SH) is widely used for treatment of patients with grades III and IV hemorrhoids. The SH is easy to perform, is associated with less pain and allows early return to normal activities. However, complications, whether severe or not, have been reported. Here, we present the case of a female patient with persistent bleeding after a SH. The bleeding was caused by the formation of granulation tissue at the stapler line, diagnosed with sigmoidoscopy, and successfully treated via transanal excision (TAE) under spinal anesthesia. The biopsy showed inflammatory granulation tissue. After the TAE, her symptom was completely gone.

Citations

Citations to this article as recorded by

A comparative study on efficacy and safety of modified partial stapled hemorrhoidopexy versus conventional hemorrhoidectomy: a prospective randomized controlled trial
Tae Gyu Kim, Chul Seung Lee, Dong Geun Lee, Choon Sik Chung, Seung Han Kim, Sang Hwa Yu, Jeong Eun Lee, Gwan Cheol Lee, Dong Woo Kang, Jeong Sub Kim, Gyu Young Jeong
Annals of Coloproctology.2025; 41(2): 145. CrossRef

Original Article

The Clinical Features and Predictive Risk Factors for Reoperation in Patients With Perianal Crohn Diseases; A Multi-Center Study of a Korean Inflammatory Bowel Disease Study Group: Jae Bum Lee, Seo-Gue Yoon, Kyu Joo Park, Kang Young Lee, Dae Dong Kim, Sang Nam Yoon, Chang Sik Yu; Ann Coloproctol. 2015;31(5):176-181. Published online October 31, 2015; DOI: https://doi.org/10.3393/ac.2015.31.5.176

3,721 View
62 Download
8 Web of Science
8 Citations

Abstract PDF

Purpose

Perianal lesions are common in Crohn disease, but their clinical course is unpredictable. Nevertheless, predicting the clinical course after surgery for perianal Crohn disease (PCD) is important because repeated operations may decrease patient's quality of life. The aim of this study was to predict the risk of reoperation in patients with PCD.

Methods

From September 1994 to February 2010, 377 patients with PCD were recruited in twelve major tertiary university-affiliated hospitals and two specialized colorectal hospitals in Korea. Data on the patient's demographics, clinical features, and surgical outcomes were analyzed.

Results

Among 377 patients, 227 patients were ultimately included in the study. Among the 227 patients, 64 patients underwent at least one reoperation. The median period of reoperation following the first perianal surgery was 94 months. Overall 3-year, 5-year, and 10-year cumulative rates of reoperation-free individuals were 68.8%, 61.2%, and 50.5%, respectively. In multivariate analysis (Cox-regression hazard model), reoperation was significantly correlated with an age of onset less than 20 years (hazard ratio [HR], 1.93; 95% confidence interval [CI], 1.07-3.48; P = 0.03), history of abdominal surgery (HR, 1.99; 95% CI, 1.08-3.64; P = 0.03), and the type of surgery. Among types of surgery, fistulotomy or fistulectomy was associated with a decreased incidence of reoperation in comparison with incision and drainage (HR, 0.19; 95% CI, 0.09-0.42; P < 0.001).

Conclusion

Young age of onset and a history of abdominal surgery were associated with a high risk of reoperation for PCD, and the risk of reoperation were relatively low in fistulotomy or fistulectomy procedures.

Citations

Citations to this article as recorded by

A nanofiber-hydrogel composite improves tissue repair in a rat model of Crohn’s disease perianal fistulas
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Kwangwoo Nam, Won Beom Jung, Seung Bum Lee, Jae Seung Soh, Song Soo Yang, Seok Won Jung
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Feihong Deng, Pianpian Xia, Zengrong Wu, Hejun Zhou, Xuehong Wang
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Predictors of Perianal Fistula Relapse in Crohn’s Disease
Audrey Malian, Pauline Rivière, Dominique Bouchard, François Pigot, Marianne Eléouet-Kaplan, Charlotte Favreau-Weltzer, Florian Poullenot, David Laharie
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Predictors of Perianal Fistula Relapse in Crohn’s Disease
Dana J Lukin
Inflammatory Bowel Diseases.2019;[Epub] CrossRef
Management of Perianal Fistulas in Crohn’s Disease
Steffen Seyfried, Alexander Herold
Visceral Medicine.2019; 35(6): 338. CrossRef
Surgical management of fistulating perianal Crohn's disease: a UK survey
M. J. Lee, N. Heywood, P. M. Sagar, S. R. Brown, N. S. Fearnhead
Colorectal Disease.2017; 19(3): 266. CrossRef
Risk of Repeat Surgery for Perianal Crohn Disease
Doo Han Lee
Annals of Coloproctology.2015; 31(5): 169. CrossRef

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