329 results match your criteria Anal Surgery Fistulotomy


Lessons learned from an audit of 1250 anal fistula patients operated at a single center: A retrospective review.

World J Gastrointest Surg 2021 Apr;13(4):340-354

Department of Statistics, Indian Council of Medical Research, New Delhi 110029, New Delhi, India.

Background: A complex anal fistula is a challenging disease to manage.

Aim: To review the experience and insights gained in treating a large cohort of patients at an exclusive fistula center.

Methods: Anal fistulas operated on by a single surgeon over 14 years were analyzed. Read More

View Article and Full-Text PDF

Fistula Laser Closure (FiLaC™) for fistula-in-ano-yet another technique with 50% healing rates?

Int J Colorectal Dis 2021 Apr 21. Epub 2021 Apr 21.

Digestive Disease Center, Bispebjerg University Hospital, Bispebjerg Bakke 23, 2400, Copenhagen, NV, Denmark.

Purpose: Treatment of ano-cutaneous fistulas remains a therapeutic challenge. Fistula Laser Closure (FiLaC™) is a relatively new technique for the treatment of ano-cutaneous fistulas. This study aimed to determine the success rate of fistula closure using FiLaC™. Read More

View Article and Full-Text PDF

Management of cryptoglandular fistula-in-ano among gastrointestinal surgeons in the Netherlands.

Tech Coloproctol 2021 Apr 15. Epub 2021 Apr 15.

Department of Surgery, Proctos Kliniek, Bilthoven, The Netherlands.

Background: Management of cryptoglandular fistula-in-ano (FIA) can be challenging. Despite Dutch and international guidelines determining optimal therapy is still quite difficult. The aim of this study was to report current practices in the management of cryptoglandular FIA among gastrointestinal surgeons in the Netherlands. Read More

View Article and Full-Text PDF

FISSIT (Fistula Surgery in Italy) study: A retrospective survey on the surgical management of anal fistulas in Italy over the last 15 years.

Surgery 2021 Apr 9. Epub 2021 Apr 9.

Proctology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy; Catholic University of Rome, Italy.

Background: Surgical treatment of anal fistulas is still a challenge. The aims of this study were to evaluate the adoption and healing rates for the different surgical techniques used in Italy over the past 15 years.

Methods: This was a multicenter retrospective observational study of patients affected by simple and complex anal fistulas of cryptoglandular origin who were surgically treated in the period 2003-2017. Read More

View Article and Full-Text PDF

Treatment Strategy for Perianal Fistulas in Crohn Disease Patients: The Surgeon's Point of View.

Ann Coloproctol 2021 Feb 28;37(1):5-15. Epub 2021 Feb 28.

Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Perianal fistula is a frequent complication and one of the subclassifications of Crohn disease (CD). It is the most commonly observed symptomatic condition by colorectal surgeons. Accurately classifying a perianal fistula is the initial step in its management in CD patients. Read More

View Article and Full-Text PDF
February 2021

A Simple Protocol to Effectively Manage Anal Fistulas with No Obvious Internal Opening.

Clin Exp Gastroenterol 2021 2;14:33-44. Epub 2021 Feb 2.

Department of Surgical Gastroenterology, Nishtha Surgical Hospital and Research Centre, Patan, Gujarat, India.

Purpose: In some anal fistulas, the internal/primary opening cannot be located even after examination and assessment on MRI or transrectal ultrasound. The efficacy of a simple new protocol to manage such therapeutically challenging fistulas was tested.

Patients And Methods: All anal fistula patients operated consecutively over 7 years were included in the study. Read More

View Article and Full-Text PDF
February 2021

Transanal Opening of Intersphincteric Space for Fistula-in-Ano.

Am Surg 2021 Jan 30:3134821989048. Epub 2021 Jan 30.

Colorectal Surgery Division, The People Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China.

Background: The role of the intersphincteric space in the pathogenesis of fistula-in-ano is being increasingly recognized. Submucosal and intersphincteric rectal abscesses have been surgically managed by laying open and draining the intersphincteric space as well as by the modified ligation of intersphincteric fistula tract (LIFT) procedure. In 2017, the transanal opening of intersphincteric space (TROPIS) technique was reported for the treatment of high, complex anal fistulae. Read More

View Article and Full-Text PDF
January 2021

Comparative study between intersphinecteric ligation of perianal fistula versus conventional fistulotomy with or without seton in the treatment of perianal fistula: A prospective randomized controlled trial.

Ann Med Surg (Lond) 2021 Jan 18;61:180-184. Epub 2020 Dec 18.

General Surgery, Faculty of Medicine, Menoufia University, Egypt.

Background: Fistula-in-ano is one of the most common benign anal conditions in daily surgical practice.The goals in the treatment of an anal fistula are to eradicate sepsis and to eliminate the primary fistula opening, any associated tracts, and any secondary openings without a change in continence. Conventional fistulotomy (lay open of the fistula tract) is a commonly used procedure and is still relied on by the majority of surgeons as the gold standard for the treatment of perianal fistula. Read More

View Article and Full-Text PDF
January 2021

Two-stage Complete Deroofing Fistulotomy Approach for Horseshoe Fistula: Successful Surgery Leaving Continence Intact.

Ann Coloproctol 2021 Jan 12. Epub 2021 Jan 12.

Sapporo Ishiyama Hospital, Sapporo, Japan.

Purpose: Surgery of the horseshoe fistula is challenging due to its complex configuration and sphincter muscle involvement. Complete deroofing fistulotomy for horseshoe fistula is highly curative with the eradication of all fistulous lesions but has been discredited for its high incontinence rate. It was replaced with the more conservative Hanley's procedure leaving the lateral tracts intact, despite its issue of recurrence. Read More

View Article and Full-Text PDF
January 2021

Comparison of the Efficacy of the Various Treatment Modalities in the Management of Perianal Crohn's Fistula: A Review.

Cureus 2020 Dec 3;12(12):e11882. Epub 2020 Dec 3.

Surgical Oncology, Cancer Treatment Centers of America, Tulsa, USA.

Crohn's disease (CD) is a transmural inflammatory bowel disease (IBD) that can affect any part of the gastrointestinal (GI) tract. With the disease's progression, adhesions and transmural fissuring, intra-abdominal abscesses, and fistula tracts may develop. An anal fistula (or fistula-in-ano) is a chronic abnormal epithelial lined tract communicating the anorectal lumen (internal opening) to the perineal or buttock skin (external opening). Read More

View Article and Full-Text PDF
December 2020

Simple fistula-in-ano: is it all simple? A systematic review.

Tech Coloproctol 2021 04 2;25(4):385-399. Epub 2021 Jan 2.

Proctology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo A. Gemelli, 8, 00168, Rome, Italy.

Background: Simple anal fistula is one of the most common causes of proctological surgery and fistulotomy is considered the gold standard. This procedure, however, may cause complications. The aim of this systematic review was to assess the surgical treatment of simple anal fistula with traditional and sphincter-sparing techniques. Read More

View Article and Full-Text PDF

[Consensus of Chinese experts on the diagnosis and treatment of anal fistula (2020)].

Authors:

Zhonghua Wei Chang Wai Ke Za Zhi 2020 Dec;23(12):1123-1130

Anal fistula is one of the most common diseases in colorectal and anal surgery. Most of them are formed after the abscess of perianal space reptures. Due to the complexity and diversity of pathological changes, the clinical efficacy of some patients is not optimistic, and there may even be serious surgical complications, including delayed healing of anal fistula or varying degrees of fecal incontinence, which significantly affect the quality of life of patients and even lead to disability. Read More

View Article and Full-Text PDF
December 2020

CAN Stryphnodendron adstringens EXTRACT IMPROVE THE RESULTS OF FISTULOTOMY FOLLOWED BY PRIMARY SPHINCTEROPLASTY IN THE TREATMENT OF TRANSSPHINCTERIC FISTULAE?

Arq Bras Cir Dig 2020 18;33(3):e1540. Epub 2020 Dec 18.

Anhanguera-Uniderp University, Campo Grande, MS, Brazil.

Background: There is still a need for progress in the treatment of transsphincteric anal fistulae and the use of herbal medicines seems promising.

Aim: To evaluate the efficacy of Stryphnodendron adstringens associated with fistulotomy and primary sphincteroplasty in the treatment of transsphincteric fistulae in rats.

Methods: Thirty Wistar rats were used, which were submitted to transsphincteric fistulas with steel wire 0; after 30 days a treatment was performed according to the group. Read More

View Article and Full-Text PDF
December 2020

Efficacy of video-assisted anal fistula treatment combined with closure of the internal opening using a stapler for Parks II anal fistula.

Ann Transl Med 2020 Nov;8(22):1517

Department of General Surgery, Xuanwu Hospital, Capital Medical University, Beijing, China.

Background: To explore the efficacy of video-assisted anal fistula treatment (VAAFT) combined with an internal-opening closure technique using a stapler in the treatment of Parks II anal fistula.

Methods: From September 2017 to June 2019, 75 patients with Parks II anal fistulas in Beijing Erlonglu Hospital were enrolled and randomly allocated into two groups. The 37 patients in the treatment group received VAAFT combined with internal-opening closure techniques, and the 38 patients in the control group were treated with anal fistulotomy with seton placement. Read More

View Article and Full-Text PDF
November 2020

High failure rates following ligation of the intersphincteric fistula tract for transsphincteric anal fistulas: are preoperative MRI measurements of the fistula tract predictive of outcome?

Colorectal Dis 2021 Apr 4;23(4):932-936. Epub 2020 Dec 4.

Department of Colorectal Surgery, Cleveland Clinic Florida, Weston, Florida, USA.

Aim: Treatment of transsphincteric fistulas (TSFs) with fistulotomy after an indwelling seton is tempered by risks of incontinence and litigation. Thus, ligation of the TSF tract has been popularized as an alternative option. We previously reported on 107 patients who underwent ligation of the intersphincteric fistula tract (LIFT), with a 46% failure rate. Read More

View Article and Full-Text PDF

Management of Complex Cryptoglandular Anal Fistula: Challenges and Solutions.

Clin Exp Gastroenterol 2020 11;13:555-567. Epub 2020 Nov 11.

Department of General Surgery, Government Medical College and Hospital, Chandigarh, India.

Anal fistulae can be a very difficult disease to manage. The management of complex fistulae is even more challenging. The risk to the fecal continence mechanism due to damage to the anal sphincters and refractoriness to the treatment (high recurrence rate) pose the two biggest challenges in the management of this disease. Read More

View Article and Full-Text PDF
November 2020

The complexity of cryptoglandular fistula-in-ano can be predicted by the distance of the external opening to the anal verge; implications for preoperative imaging?

Tech Coloproctol 2021 01 12;25(1):109-115. Epub 2020 Nov 12.

Department of Surgery, ETZ (Elisabeth, TweeSteden Ziekenhuis), Doctor Deelenlaan 5, 5042 AD, Tilburg, The Netherlands.

Background: Many surgeons believe that the distance from the external opening to the anal verge (DEOAV) predicts the complexity of a cryptoglandular fistulas-in-ano and, therefore, predicts the need for additional imaging. However, there is no evidence to support this. The primary aim of this study was to determine if DEOAV can predict the complexity of a fistula. Read More

View Article and Full-Text PDF
January 2021

A meta-analysis of marsupialisation versus none in the treatment of simple fistula-in-ano.

Int J Colorectal Dis 2021 Mar 6;36(3):429-436. Epub 2020 Oct 6.

Department of Colorectal Surgery, Beaumont Hospital, Dublin 9, Ireland.

Introduction: Marsupialisation of post-fistulotomy wounds results in a smaller raw surface area and may improve postoperative outcomes. However, it remains a variable practice. We performed a systematic review and meta-analysis to evaluate the effectiveness of marsupialisation in the treatment of simple fistula-in-ano. Read More

View Article and Full-Text PDF

Opioid Prescribing Patterns After Anorectal Surgery.

J Surg Res 2020 11 11;255:632-640. Epub 2020 Jul 11.

Case Western Reserve University School of Medicine, Cleveland, OH; University Hospitals Cleveland Medical Center/UH-RISES: Research in Surgical Outcomes & Effectiveness Center), Cleveland, OH. Electronic address:

Background: Anorectal procedures are frequently performed and have the potential to be particularly painful. There are no evidence-based guidelines regarding opioid prescribing after anorectal surgery and limited data on how surgeons determine opioid prescriptions after anorectal procedures. We hypothesize significant variations in prescribing practices. Read More

View Article and Full-Text PDF
November 2020

Indications for surgical intervention in a postpartum pelvic floor specialty clinic.

Int Urogynecol J 2020 Nov 10;31(11):2233-2236. Epub 2020 Jul 10.

University of Michigan Department of Obstetrics and Gynecology, L3211 Women's Hospital, SPC 5276, 1500 East Medical Center Drive, Ann Arbor, MI, 48109, USA.

Objective: To determine the prevalence and type of surgical procedures undergone by postpartum women seen in a specialty postpartum pelvic floor clinic over 11 years.

Methods: This study was a retrospective chart review of patients requiring surgical intervention within a 1-year period after their initial visit to the Michigan Healthy Healing After Delivery (MHHAD) clinic at the University of Michigan from July 2007 through January 2019. Chart review was performed to abstract demographics, obstetric data, indication for postpartum clinic visit, primary and secondary indications for surgery, and procedures performed. Read More

View Article and Full-Text PDF
November 2020

A Multicenter Randomized Controlled Trial Comparing Safety, Efficacy, and Cost-effectiveness of the Surgisis Anal Fistula Plug Versus Surgeon's Preference for Transsphincteric Fistula-in-Ano: The FIAT Trial.

Ann Surg 2021 03;273(3):433-441

Birmingham Clinical Trials Unit (BCTU), University of Birmingham, Birmingham, UK.

Objective: To undertake a randomized comparison of the Biodesign Surgisis anal fistula plug against surgeon's preference in treating cryptoglandular transsphincteric fistula-in-ano.

Summary Background Data: The efficacy of the Biodesign Surgisis anal fistula plug in healing anal fistulae is uncertain.

Methods: Participants were randomized to the fistula plug with surgeon's preference (advancement flap, cutting seton, fistulotomy, Ligation of the Intersphincteric Fistula Tract procedure). Read More

View Article and Full-Text PDF

The effect of suture selection in complex anal fistulas on the success of cutting seton placement and patient comfort.

Pak J Med Sci 2020 May-Jun;36(4):816-820

Dr. Ogun Ersen, Department of General Surgery, Afyonkarahisar Health Sciences University, Afyon, Turkey.

Objective: The aim of our study was to compare the success rates of suture selection, recovery times and pain associated with local wound infection and seton placement in patients undergoing cutting seton placement for complex anal fistula.

Methods: The study included a total of 90 patients who were admitted with the diagnosis of complex anal fistula between January 2015 and July 2018.

Results: The first session and other revision appointments demonstrated that the number of patients who required fistulotomy was significantly higher in group-1 as the seton failed to complete the transection (p = 0. Read More

View Article and Full-Text PDF

Laser ablation of fistula tract (LAFT) and complex fistula-in-ano: "the ideal indication" is becoming clearer….

Tech Coloproctol 2020 07 24;24(7):695-701. Epub 2020 Apr 24.

Department of MedicoSurgical Proctology, Institut Léopold Bellan, Groupe Hospitalier Paris Saint-Joseph, Paris, France.

Background: An initial study enabled us to achieve 60% healing of high transsphincteric fistula-in-ano with laser ablation of fistula tract (LAFT) The purpose of this new study was to investigate other predictors of the success of this technique in the treatment of complex anoperineal fistulas.

Methods: All patients treated with LAFT in our department between May 2017 and October 2018 were included prospectively. LAFT was used for patients with complex anoperineal fistulas who were at high risk of anal incontinence after fistulotomy. Read More

View Article and Full-Text PDF

Intra-anal fistulotomy with marsupialization for recurrent high intersphincteric fistula - a video vignette.

Colorectal Dis 2020 Oct 30;22(10):1450-1451. Epub 2020 Apr 30.

Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.

View Article and Full-Text PDF
October 2020

Fistulectomy and primary sphincteroplasty (FIPS) to prevent keyhole deformity in simple anal fistula: a single-center retrospective cohort study.

Acta Chir Belg 2020 Apr 15:1-6. Epub 2020 Apr 15.

Department of General Surgery, Heilig-Hartziekenhuis, Lier, Belgium.

Fistulotomy remains the gold standard for the surgical treatment of simple anal fistula, but may cause fecal incontinence and a characteristic anal 'keyhole' deformity. Although seemingly trivial, keyhole deformity may lead to bothersome symptoms such as anal pruritus and fecal soiling. This study aims to evaluate the efficacy of fistulectomy and primary sphincteroplasty (FIPS), a technique with immediate sphincter reconstruction, in the treatment of simple anal fistula and the prevention of keyhole deformity created by simple fistulotomy. Read More

View Article and Full-Text PDF

Combined Fistulotomy and Contralateral Anal Internal Sphincterotomy for Recurrent and Complex Anal Fistula to Prevent Recurrence.

Ann Coloproctol 2020 Apr 17;36(2):122-127. Epub 2020 Mar 17.

Faculty of Medicine, Universitas Gadjah Mada, Yogyakarta, Indonesia.

The ideal intervention in the treatment of perianal fistula prevents the onset of infection to speed healing and prevent fistula recurrence while maintaining the function of the anal sphincter. Currently, there is no consensus on the best recommended surgical technique for perianal fistula management. Several studies have shown that fistulotomy was an easy and safe procedure for treatment of perianal fistula. Read More

View Article and Full-Text PDF

Long-term Outcomes of Laser Ablation of Fistula Tract for Fistula-in-Ano: A Considerable Option in Sphincter Preservation.

Dis Colon Rectum 2020 06;63(6):831-836

Department of surgery, Bursa Uludag University School of Medicine, Bursa, Turkey.

Background: Ablation of anal fistula tract using a radial laser-emitting probe is a sphincter-preserving technique.

Objective: The purpose of this study was to assess long-term outcomes of laser ablation of fistula tract.

Design: This was a retrospective analysis of the long-term outcomes of 100 patients who underwent laser ablation of fistula tract. Read More

View Article and Full-Text PDF

Comparison of surgical outcomes between video-assisted anal fistula treatment and fistulotomy plus seton for complex anal fistula: A propensity score matching analysis - Retrospective cohort study.

Int J Surg 2020 Mar 1;75:99-104. Epub 2020 Feb 1.

Department of General Surgery, Yangpu Hospital, Tongji University School of Medicine, Shanghai, China; Institute of Gastrointestinal Surgery and Translational Medicine, Tongji University School of Medicine, Shanghai, China. Electronic address:

Background: Video-assisted anal fistula treatment (VAAFT) is a new minimally invasive technique for treating complex anal fistula (CAF). This study aimed to compare the efficacy and safety of VAAFT with fistulotomy plus seton (FPS) for treatment of CAF.

Materials And Methods: We included 148 patients with CAF receiving surgical treatment at our hospital between January 2017 and December 2018. Read More

View Article and Full-Text PDF

The management of cryptoglandular fistula-in-ano.

Br J Hosp Med (Lond) 2020 Jan 31;81(1):1-9. Epub 2020 Jan 31.

Colorectal Department, Aintree University Hospital NHS Foundation Trust, Liverpool, UK.

Idiopathic cryptoglandular fistula-in-ano is a common pathological condition. Fistula-in-ano has been managed by a number of surgical techniques, and there is still no consensus regarding the management of this condition. Surgical techniques aim to treat and cure the fistula-in-ano with minimal risk of recurrence or complications, and to maintain patient continence. Read More

View Article and Full-Text PDF
January 2020