The management of @entity9292 in @entity1 with @entity8787 continues to be extremely challenging and, indeed, somewhat frustrating. Despite a global closure rate of about 75%, all @entity1 should be informed about the risk of infection, early failure, eventual temporary disfunctioning stoma and the possibility of late recurrence (about 15%). Closure of a RVF in @entity30 should not be considered an easy undertaking, especially in @entity1 with several Crohn localisations. The technique can be adapted to the local situation. Construction of a temporary stoma is not mandatory. However, stoma construction seems to be beneficial when extensive perianal or recto-vaginal dissection including eventual tissue interposition is required. Advancement flaps are an attractive surgical alternative for the management of all anal transsphincteric @entity292 , also in @entity30 , because sphincter architecture and function are well preserved. Improved medical treatment and the changed approach from conservative to reparative surgery may well have resulted in a decreased need or at least in a delay of the need for a proctectomy. Although the surgical principles of advancement flap techniques are sound, these techniques have not been used for many decades. Skills needed, problematic approach, suboptimal quality of local tissues have contributed to its selective use and to the absence of prospective randomised studies.

Advancement flap plasty for the closure of anal and recto-vaginal @entity292 in XXXX .

@entity1 :: ('9606', 'Species') :: ['patients'] @entity9292 :: ('MESH:D012003', 'Disease') :: ['anal fistulas'] @entity292 :: ('MESH:D005402', 'Disease') :: ['fistulas'] @entity8787 :: ('MESH:C535541', 'Disease') :: ['IBD'] @entity30 :: ('MESH:D003424', 'Disease') :: ["Crohn's disease"]
@entity30 :: (MESH:D003424,Disease) :: ['Crohn's disease']
