Predictors of rectovaginal fistula recurrence in patients with Crohn's disease

AIM: to determine the risk factors rectovaginal fistula (RVF) recurrence in patients with CD.

PATIENTS AND METHODS: a retrospective analysis included 60 patients with perianal fistulizing Crohn disease and rectovaginal fistulas (2016–2024). In order to identify the risk factors of RVF recurrence, the clinical and history data of 28 patients who underwent radical treatment for RVF were collected and analyzed.

RESULTS: the follow-up period for the patients after surgery was 3–12 moths. According to clinical and instrumental data, recurrence of the disease occurred in 11/28 (39%) females. Multifactorial analysis showed increase the likeli-hood of RVF recurrence was the avoid of a loose seton at the first stage (odds ratio (ОR) = 27.49; 95% confidence interval (CI): 2.02–374.8; p = 0.013). Absence of biological therapy to treat Crohn's disease (ОR = 15.77; 95% CI: 1.13–220.4; p = 0.04) reduces the incidence of RVF recurrence as well.

CONCLUSION: patients with RVF represent the most challenging cohort of patients with perianal fistulizing Crohn disease (PFCD) due the significant recurrence rate, however combined two-step approach and careful assessment of risk factors before surgery improve the results.

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