What Researchers Did
Researchers at a US colorectal surgery center matched 53 patients who received HBOT during complex perineal fistula repair against 159 controls treated without HBOT, comparing healing and recurrence rates.
What They Found
HBOT patients had worse baseline cases (longer fistula duration, more prior surgeries, higher diversion rates) yet achieved similar healing at 6 months (85% HBOT vs. 76% controls, p=0.18). Among patients with 3 or more prior failed repairs, healing was significantly higher with HBOT (85% vs. 66%, p=0.04). After stoma reversal, recurrence was 5.9% with HBOT versus 26.5% without (p=0.035).
What This Means for Canadian Patients
For Canadian patients with Crohn's disease or other conditions causing complex, recurring perineal fistulas that have failed multiple surgeries, HBOT may significantly improve the chance of lasting repair, especially after stoma reversal. Canadian colorectal programs treating refractory fistulas should consider HBOT as part of a multidisciplinary treatment plan.
Canadian Relevance
No direct Canadian connection identified.
Study Limitations
This retrospective matched cohort cannot fully control for all baseline differences, and follow-up was shorter in the HBOT group, which may have underestimated recurrence in that group.