Intestinal surgery in association with perianal disease consists of either proximal diversion (with or without resection), proximal resection with re-establishment of continuity, or proctectomy with the creation of a permanent stoma. Proximal intestinal resection in order to improve perianal symptoms has been met with mixed results. Human and coworkers from Sweden identified a close association between proximal intestinal disease and anal symptoms. Resection of proximal disease without intestinal recurrence resulted in complete perineal healing in 80% of patients, but all patients with recurrent intestinal disease had persistent perianal disease. Long-term follow-ups of patients with the perianal disease treated at the Mayo Clinic revealed a similar phenomenon. The majority of patients who underwent intestinal resection showed a significant improvement in the perianal disease.
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