355 results match your criteria Anal Surgery Fistulotomy


Comparison between recent sphincter-sparing procedures for complex anal fistulas-ligation of intersphincteric tract transanal opening of intersphincteric space.

Authors:
Pankaj Garg

World J Gastrointest Surg 2022 May;14(5):374-382

Department of Colorectal Surgery, Garg Fistula Research Institute, Panchkula 134113, India.

Complex anal fistulas are difficult to treat. The main reasons for this are a higher recurrence rate and the risk of disrupting the continence mechanism because of sphincter involvement. Due to this, several sphincter-sparing procedures have been developed in the last two decades. Read More

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Guidelines to diagnose and treat peri-levator high-5 anal fistulas: Supralevator, suprasphincteric, extrasphincteric, high outersphincteric, and high intrarectal fistulas.

World J Gastroenterol 2022 Apr;28(16):1608-1624

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

Supralevator, suprasphincteric, extrasphincteric, and high intrarectal fistulas (high fistulas in muscle layers of the rectal wall) are well-known high anal fistulas which are considered the most complex and extremely challenging fistulas to manage. Magnetic resonance imaging has brought more clarity to the pathophysiology of these fistulas. Along with these fistulas, a new type of complex fistula in high outersphincteric space, a fistula at the roof of ischiorectal fossa inside the levator ani muscle (RIFIL), has been described. Read More

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A Retrospective Critique of the Various Sphincter-preserving Surgical Procedures for Ischiorectal Fistula.

J Anus Rectum Colon 2022 27;6(2):100-112. Epub 2022 Apr 27.

Coloproctology Center Takano Hospital, Kumamoto, Japan.

In the 1950s, the cause of anal fistulas was identified as an infection of the anal gland (cryptoglandular infection theory). Thereafter, treatment for this disorder began in the 1960s with the lay-open procedure, which involved incising the sphincter and the fistula tract. However, it was found that too much invasion into the sphincter could result in postoperative fecal incontinence. Read More

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The Effect of Qingre Huayu Recipe on Wound Healing after Anal Fistulotomy in Sprague-Dawley Rats.

Comput Math Methods Med 2022 19;2022:9397478. Epub 2022 Apr 19.

Department of Proctology, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, No. 164 Lanxi Road, Shanghai 200333, China.

Anal fistula is a common anorectal disease. At present, most scholars believe that its pathogenesis is related to anal gland infection. Anal fistula cannot heal on its own after the onset and must be treated surgically. Read More

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Anal Fistula Human Amniotic Membrane Endosealing (F-HAME): A Proof of Concept Study.

Front Surg 2022 28;9:869923. Epub 2022 Mar 28.

II Surgery Unit, Regional Hospital Treviso, Treviso, Italy.

The treatment of cryptoglandular anal fistula (AF) is often a challenge for surgeons. Several sphincter-saving procedures have been described as an alternative to fistulotomy, with the common goal of promoting healing and preserve anal continence. The aim of this proof of concept study was to assess the outcomes of human amniotic membrane (HAM) implantation in cryptoglandular transphincteric AF. Read More

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Sphincter-Preserving Fistulectomy Is an Effective Minimally Invasive Technique for Complex Anal Fistulas.

Front Surg 2022 22;9:832397. Epub 2022 Mar 22.

Department of Colorectal Surgery, Suzhou TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou, China.

Background: The optimal treatment of complex anal fistulas remains unclear, though many different sphincter-preserving procedures have been described. A minimally invasive technique with a better outcome is desired. The purpose of this study was to present a new technique-sphincter-preserving fistulectomy (SPF) and its clinical outcomes. Read More

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Video-assisted anal fistula treatment for complex anorectal fistulas in adults: a systematic review and meta-analysis.

Tech Coloproctol 2022 Mar 28. Epub 2022 Mar 28.

Department of Anorectal Center, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao, Shandong, China.

Background: Video-assisted anal fistula treatment (VAAFT) has gained increasing acceptance as a sphincter-sparing procedure for treating complex anorectal fistulas (CAF), but no unequivocal conclusions can yet be drawn regarding its ultimate effectiveness. We reviewed the literature and performed a meta-analysis to evaluate the efficacy and safety of VAAFT in CAF patients.

Methods: The study protocol was registered with the PROSPERO database (CRD42021279085). Read More

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Long-term outcomes of an acellular dermal matrix for the treatment of complex cryptoglandular anal fistula: a pilot study.

Tech Coloproctol 2022 Jun 25;26(6):453-459. Epub 2022 Feb 25.

Department of Advanced Medical and Surgical Sciences, Colorectal Surgery, Vall d'Hebron University Hospital, Barcelona, Spain.

Backgound: Effective, standardized treatments for complex anal fistula (CAF) still represent a clinical challenge. Emerging procedures attempted to achieve the healing rates of fistulotomy whilst preserving sphincter function. Acellular dermal matrix (ADM) used as a plug inserted through the fistulous tract is among newer treatment options. Read More

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Horseshoe Fistulae in the Age of LIFT.

J Gastrointest Surg 2022 05 22;26(5):1077-1083. Epub 2022 Jan 22.

Division of Colon and Rectal Surgery, Lahey Hospital and Medical Center, 41 Mall Road, Burlington, MA, 01805, USA.

Background: Horseshoe fistula is a challenging benign anorectal condition to treat. The aim of this study was to assess the utilization and success of different definitive fistula repair techniques in the treatment of horseshoe fistula.

Methods: This was a retrospective case series which included all patients who were treated for horseshoe fistula from 2006 to 2019 at a single, tertiary care center and whom had at least one follow-up visit. Read More

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Jump Technique versus Seton Method for Anal Fistula Repair: A Randomized Controlled Trial.

J Invest Surg 2022 Jun 6;35(6):1217-1223. Epub 2022 Jan 6.

Plastic Surgery Department, Cleveland Clinic, Cleveland, OH, USA.

Background: The treatment of anal fistula has been a conundrum for surgeons over the years. Various methods such as fistulotomy, fistulectomy, seton, ligation of the intersphincteric fistula tract (LIFT), advancement flaps, fibrin glue, and plugs are well-known techniques. Yet, they may be followed by several considerable complications, including incontinency and recurrence. Read More

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Marsupialization of fistulotomy wound in an intersphincteric fistula - A Video Vignette.

Colorectal Dis 2022 May 21;24(5):668-669. Epub 2022 Jan 21.

Department of General Surgery, Memorial Ankara Hospital, Ankara, Turkey.

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Effectiveness and Prognosis: Drainage Skin-Bridge Sparing Surgery Combined with Fistulotomy versus Fistulotomy Only in the Treatment of Anal Fistula.

J Healthc Eng 2021 28;2021:6940072. Epub 2021 Nov 28.

Department of Anorectal Surgery, The First People's Hospital of Fuyang Hangzhou, Hangzhou, Zhejiang 311400, China.

Objective: This study intends to analyze the difference in the efficacy of drainage skin-bridge sparing surgery combined fistulotomy (DSCF) and fistulotomy alone.

Methods: 125 patients with anal fistula were enrolled as study subjects and randomly divided into control group (CG) and observation group (OG) by double-blind lottery. The CG received drainage skin-bridge sparing surgery with fistulotomy and the OG received fistulotomy only. Read More

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[Symptoms, diagnostic and therapy of perianal disease in patients with inflammatory bowel diseases].

Ther Umsch 2021 ;78(9):547-558

Klinik für Gastroenterologie/Hepatologie, Kantonsspital St. Gallen.

Symptoms, diagnostic and therapy of perianal disease in patients with inflammatory bowel diseases Inflammatory bowel diseases (IBD) frequently affect the perianal region. Due to the great functional importance of the anorectum, this frequently results in a significant burden of disease for the patient. For assessment of perianal IBD symptoms, the clinical history is of great importance. Read More

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October 2021

Minor Sphincter Sparing Surgery for Successful Closure of Perianal Fistulas in Patients with Crohn's Disease.

J Clin Med 2021 Oct 14;10(20). Epub 2021 Oct 14.

Department of General, Visceral and Transplantation Surgery, University Hospital Muenster, Albert-Schweitzer-Campus 1, Building W1, 48149 Muenster, Germany.

The purpose of this study is to demonstrate that repetitive minor surgical procedures allow for a high rate of permanent closure of perianal fistulas in patients with Crohn's disease (CD). Patients with perianal fistulizing CD (PFCD) who underwent perianal surgery at the University Hospital of Muenster between 2003 and 2018 were assessed for fistula characteristics and surgical procedures. We included 45 patients (m:f = 28:17) with a mean age of 27 years at first fistula appearance. Read More

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October 2021

Predictive Risk Factors of the Conversion from Video-Assisted Treatment of Anal Fistula to Seton Fistulotomy.

J Laparoendosc Adv Surg Tech A 2022 Jun 22;32(6):634-638. Epub 2021 Oct 22.

Department of Colorectal Surgery, Beijing Erlonglu Hospital, Beijing, People's Republic of China.

To identify the risk factors of converting from video-assisted anal fistula treatment (VAAFT) to seton fistulotomy. A total of 180 patients registered to undergo VAAFT between January 2016 and June 2020 at the Erlonglu Hospital. Intraoperative examination of the fistula tract revealed that the patients were assigned to undergo the VAAFT operation and seton fistulotomy. Read More

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Is fistulotomy with immediate sphincter reconstruction (FISR) a sphincter preserving procedure for high anal fistula? A systematic review and meta-analysis.

Colorectal Dis 2021 12 22;23(12):3073-3089. Epub 2021 Oct 22.

Robin Phillips' Fistula Research Unit, St Mark's Hospital and Academic Institute, Harrow, UK.

Aim: This systematic review aimed to assess the outcomes of fistulotomy or fistulectomy and immediate sphincter repair (FISR) in relation to healing, incontinence and sphincter dehiscence both overall and in patients with high anal fistulae.

Methods: Medline, Embase and The Cochrane library were searched for studies of patients undergoing FISR for anal fistula. Data regarding healing, continence and sphincter dehiscence were extracted overall and for high anal fistulae. Read More

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December 2021

Long-term Evaluation of Fistulotomy and Immediate Sphincteroplasty as a Treatment for Complex Anal Fistula.

Dis Colon Rectum 2021 11;64(11):1374-1384

Department of General Surgery, Colorectal Unit, Elche University Hospital, University Miguel Hernández of Elche, Alicante, Spain.

Background: Fistulotomy with immediate sphincteroplasty is a technique that can heal fistulas and decrease fecal incontinence more effectively than fistulotomy alone, in selected patients.

Objective: We aimed to perform a long-term evaluation of fecal incontinence after fistulotomy and immediate sphincteroplasty in patients with complex anal fistula.

Design: This prospective study included patients undergoing fistulotomy and immediate sphincteroplasty for complex anal fistula from January 2000 to December 2010. Read More

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November 2021

External sphincter-sparing anal fistulotomy (ESSAF): a simplified technique for the treatment of fistula-in-ano.

Tech Coloproctol 2021 Dec 1;25(12):1311-1318. Epub 2021 Oct 1.

Department of General Surgery, Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, POB 12000, Jerusalem, 91120, Israel.

Background: Fistula-in-ano due to cryptoglandular disease is a common condition. While a simple anal fistula can be treated successfully by a fistulotomy, the risk of potential damage to the anal sphincters and subsequent poor functional outcomes persist in a large portion of patients with complex fistulae. Several sphincter-preserving treatment procedures have been described for complex fistulae over the past 3 decades, with variable results and complication rates, and no procedure is proven to be superior to the others. Read More

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December 2021

[Cryptoglandular anal fistulas].

Ugeskr Laeger 2021 09;183(36)

Cryptoglandular anal fistulas (AF) cause recurrent anal abscesses and patients risk multiple surgeries due to low healing rates of sphincter-saving procedures. Knowledge of anal anatomy and imaging with MRI or endoanal sonography is crucial to classify AF as simple or complex depending on risk of anal incontinence after fistulotomy as summarised in this review. Fistulotomy has healing rates of > 90%, risks incontinence, and the procedure is reserved for simple fistulas. Read More

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September 2021

Seton in high anal fistula.

Trop Doct 2022 Jan 6;52(1):110-115. Epub 2021 Sep 6.

Professor, Department of general Surgery, Nilratan Sircar Medical College and Hospital, Kolkata, India.

The use of seton still remains a reasonably valid option for its simplicity and optimal results in treating high anal fistulae. Ours was a single-centre retrospective study on patients with supra-sphincteric and transsphincteric types of high anal fistula, using the 'kharsutra' as seton. The first group were treated with a seton alone, while the second with a seton and partial fistulotomy. Read More

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January 2022

Sphincter damage during fistulotomy for perianal fistulae and its relationship with faecal incontinence.

Langenbecks Arch Surg 2021 Nov 1;406(7):2497-2505. Epub 2021 Sep 1.

Colorectal Surgery Unit, Department of General and Digestive Surgery, Biomedical Research Institute INCLIVA, Hospital Clínico Universitario, Avd. Blasco Ibañez, 17, 46010, Valencia, Spain.

Background: The length of sphincter which can be divided during fistulotomy for perianal fistula is unclear. The aim was to quantify sphincter damage during fistulotomy and determine the relationship between such damage with symptoms and severity of faecal incontinence and long-term quality of life (QOL).

Methods: A prospective cohort study was performed over a 2-year period. Read More

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November 2021

Long-term outcomes after anal fistula surgery: results from two university hospitals in Thailand.

Ann Coloproctol 2022 Apr 7;38(2):133-140. Epub 2021 Jun 7.

Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.

Purpose: This study aimed to evaluate long-term outcomes after anal fistula surgery from university hospitals in Thailand.

Methods: A prospectively collected database of patients with cryptoglandular anal fistula undergoing surgery from 2011 to 2017 in 2 university hospitals was reviewed. Outcomes were treatment failure (persistent or recurrent fistula), fecal continence status, and chronic postsurgical pain. Read More

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Surgery for anal fistulae: state of the art.

Authors:
Mario Pescatori

Int J Colorectal Dis 2021 Oct 31;36(10):2071-2079. Epub 2021 May 31.

Coloproctology Units of Parioli and Cobellis Clinics, Rome and Vallo della Lucania, Italy.

Background And Aim: Anal fistulae (AF) are considered a challenge for colorectal surgeons, as they recur if not properly operated. Being a septic disease, they are correlated with immunodeficiency and surgery may be followed by anal incontinence (AI). The aim of this paper is to suggest a state-of-the-art treatment of AF. Read More

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October 2021

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

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

Int J Colorectal Dis 2021 Sep 21;36(9):1831-1837. 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

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September 2021

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

Tech Coloproctol 2021 06 15;25(6):709-719. 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

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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 09 10;170(3):689-695. Epub 2021 Apr 10.

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

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September 2021

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

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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

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February 2021

Transanal opening of the intersphincteric space: a novel sphincter-sparing procedure to treat 325 high complex anal fistulas with long-term follow-up.

Colorectal Dis 2021 May 19;23(5):1213-1224. Epub 2021 Feb 19.

Indian Council of Medical Research, New Delhi, India.

Aim: Sepsis in the intersphincteric plane behaves like an abscess in a closed space and is present in most complex fistulas. Ignoring this sepsis is a cause of recurrence. Complex fistulas can be successfully managed by transanal opening of the intersphincteric space (TROPIS) into the anal canal. Read More

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