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Marc D. Basson, MD, PhD
Detroit, Mich

Arch Surg. 2002;137:778.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Anorectal problems afflict one fifth of all patients with Crohn disease. Some series report 80% to 90% surgical success rates in selected patients,^1-4 but postoperative complications substantially impair some patients.^5-7 Thus, patient selection is critical in deciding whether to be aggressive or to perform conservative procedures such as simple drainage or seton placement. Pikarksy and coauthors propose that a simple score might predict surgical outcome. Prospectively collected data and an a priori scoring system yielded a dichotomous distribution that correlated with postoperative outcome when the results were analyzed retrospectively. The study group was small and heterogeneous regarding surgical indications and procedures. Furthermore, half of the patients underwent "conservative procedures" and therefore do not help test the hypothesis that these scores predict whether an aggressive procedure is likely to be successful. (Although potentially corrective, fibrin glue instillation does not carry the same level of postoperative risk . . . [Full Text of this Article]

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Perianal Crohn Disease: A New Scoring System to Evaluate and Predict Outcome of Surgical Intervention
Alon J. Pikarsky, Pascal Gervaz, and Steven D. Wexner
Arch Surg. 2002;137(7):774-778.
ABSTRACT | FULL TEXT