Clinical Efficacy of Perianal Surgery Combined With Anti-tumor Necrosis Factor-α Agents in Treating Perianal Fistulizing Crohn's Disease:A Meta-analysis
10.3969/j.issn.1008-7125.2025.01.004
- VernacularTitle:肛周手术联合抗肿瘤坏死因子-α制剂治疗克罗恩病肛瘘临床疗效的meta分析
- Author:
Zepeng CHEN
1
;
Xingchen WANG
1
;
Yibin PAN
1
;
Yongqing CAO
1
Author Information
1. 上海中医药大学附属龙华医院肛肠科(200032);上海中医药大学
- Publication Type:Journal Article
- Keywords:
Crohn Disease;
Perianal Fistula;
Tumor Necrosis Factor-α;
Therapy;
Meta-Analysis
- From:
Chinese Journal of Gastroenterology
2025;30(1):22-27
- CountryChina
- Language:Chinese
-
Abstract:
Background:The incidence of perianal fistulizing Crohn's disease is increasing and can seriously affect patients'quality of life.The efficacy of perianal surgery combined with biological agents for perianal fistulizing Crohn's disease remains to be clarified.Aims:To evaluate the clinical efficacy of perianal surgery combined with anti-tumor necrosis factor(TNF)-α agents in the treatment of perianal fistulizing Crohn's disease systematically.Methods:Cohort studies on perianal surgery combined with anti-TNF-α agents in the treatment of perianal fistulizing Crohn's disease were retrieved from PubMed,Web of Science,Embase,Cochrane Library,CNKI,Wanfang Data,and SinoMed.The retrieval time span was from the establishment of each database to October 30,2024.Literatures were enrolled according to the inclusion and exclusion criteria,and the data were extracted.Newcastle-Ottawa scale was used to evaluate the quality of literature.Meta-analysis was conducted by RevMan 5.4 software.Results:A total of 9 literatures involving 736 patients with perianal fistulizing Crohn's disease were enrolled.Meta-analysis showed that perianal surgery combined with anti-TNF-α agents shortened the healing time of anal fistula(WMD=-0.76,95%CI:-1.06--0.46;Z=4.91,P<0.000 01),decreased the recurrence rate of perianal fistula(OR=0.47,95%CI:0.26-0.84;Z=2.55,P=0.01),and reduced the perianal disease activity index(PDAI)score(WMD=-1.51,95%CI:-1.84--1.18;Z=8.91,P<0.000 01)when compared with perianal surgery alone.However,no significant differences in complete healing rate,partial healing rate,and reoperation rate were found between the two groups(all P>0.05).Conclusions:Perianal surgery combined with anti-TNF-α agents in the treatment of perianal fistulizing Crohn's disease demonstrates superior efficacy compared to perianal surgery alone in terms of shortening healing time,reducing recurrence rate and decreasing PDAI score.
