Annals of surgery
August 14, 2026 · via Europe PMC
Incidence and Risk Factors for Persistent Perineal Sinus After Proctectomy in Crohn Disease: A Single-center Retrospective Cohort Study.
De Coster W, D'Hoore AJL, Vandeuren K, Van Langenhoven L, Fieuws S, Wolthuis A, Bislenghi G.
AI summary — for doctors, generated from the abstract only
Persistent perineal sinus after proctectomy for Crohn disease is common, yet most patients eventually heal, and older age at surgery was the only independent predictor of faster healing.
What was studied
Single-center retrospective cohort of 139 patients who underwent proctectomy for Crohn disease between 1993 and 2023, assessing incidence of persistent perineal sinus (wound unhealed at 6 months or more) and associated risk factors with regression analyses.
Key findings
- Persistent perineal sinus occurred in 26 of 139 patients
- Healing was 81.30% at 6 months and 93.50% at 12 months, with a median healing time of 1.80 months
- Persistent sinus was associated with younger age (OR 0.79; P=0.014) and omentoplasty (OR 2.60; P=0.036)
- After correcting for year of surgery, only older age independently predicted faster healing (OR 0.90; P=0.005); 3 or more therapy lines showed a nonsignificant protective effect (OR 0.36; P=0.067)
Clinical relevance
Surgeons can counsel patients that delayed perineal healing is frequent but usually resolves, and that younger patients may need closer follow-up. The suggestion that better control of systemic inflammation helps is a hypothesis rather than a proven strategy.
Who should care
Limitations
Retrospective single-center design spanning three decades, with patient and treatment characteristics changing over time (patients operated after 2011 differed substantially). The omentoplasty association did not persist after adjusting for year of surgery.
Most Crohn proctectomy wounds heal; younger age is the main marker of delayed healing, and the inflammation-control message needs confirmation.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
Objective
This retrospective cohort study aimed to determine the incidence of persistent perineal sinus (PPS) after proctectomy for Crohn disease (CD) and to identify associated risk factors.
Summary background data
Proctectomy remains necessary in a subset of patients with CD, yet impaired perineal wound healing and PPS continue to represent major sources of postoperative morbidity.
Methods
All patients undergoing proctectomy for CD between 1993 and 2023 at a tertiary referral center were included. The primary outcome was development of PPS, defined as a perineal wound remaining unhealed for ≥6 months after proctectomy. Associated risk factors were analyzed using regression analyses.
Results
Among 139 patients, 66.20% were women, and PPS occurred in 26. Healing was 81.30% (95% CI, 74.40%-87.30%) at 6 months and 93.50% (95% CI, 88.60%-96.80%) at 12 months; median healing time was 1.80 months (IQR, 0.90-4.60).Patients operated after 2011 (n=113, 81.30%) were significantly older, more ASA III, and active smokers, with longer disease duration, lower CRP, and higher number of advanced therapies.PPS was associated with younger age (OR 0.79; P =0.014) and omentoplasty (OR 2.60; P =0.036). After correction for year of surgery, only older age independently predicted faster healing (OR 0.90; 95% CI, 0.83-0.97; P =0.005), while ≥3 therapy lines showed a nonsignificant protective effect (OR 0.36; 95% CI, 0.12-1.07; P =0.067).
Conclusion
Although PPS remains frequent after proctectomy for Crohn disease, most patients ultimately achieve perineal healing. Older age at surgery is the only independent predictor of faster healing. Improved control of systemic inflammation may reduce the risk of PPS.
DOI
10.1097/sla.0000000000007168
PMID
42599762
PMCID
PMC13652123
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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