7,559 results match your criteria Fistula-in-Ano


LONG-TERM OUTCOMES OF LIGATION OF INTERSPHINCTERIC FISTULA TRACT FOR COMPLEX FISTULA-IN-ANO: MODIFIED OPERATIVE PROCEDURE EXPERIENCE.

Arq Bras Cir Dig 2018 Dec 6;31(4):e1404. Epub 2018 Dec 6.

Suzhou Affiliated Hospital of Nanjing University of Chinese Medicine, Colorectal Surgery, Su zhou, Jiang su, China.

Background: It is important but difficult to treat complex fistula-in-ano due to the high recurrent rate and following incontinence. Ligation of the intersphincteric fistula tract (LIFT), a novel surgical procedure with the advantage of avoiding anal incontinence, has a variable success rate of 57-94.4 %. Read More

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December 2018
1 Read

Anal fistula plug versus rectal advancement flap for the treatment of complex cryptoglandular anal fistulas: a system review and meta-analysis of studies with long term follow-up.

Colorectal Dis 2018 Nov 30. Epub 2018 Nov 30.

Department of Intensive Care Unit, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.

Aim: To compare the effectiveness of the anal fistula plug (AFP) with the rectal advancement flap (RAF) for complex cryptoglandular anal fistulas.

Methods: We conducted a literature search to identify relevant available articles published without language restriction from EMBASE and PubMed databases and the Cochrane Library. Studies comparing outcomes with the AFP versus RAF for complex cryptoglandular anal fistulas were eligible for inclusion. Read More

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November 2018
3 Reads

Partial Stapled Hemorrhoidopexy Versus Circumferential Stapled Hemorrhoidopexy for Grade III to IV Prolapsing Hemorrhoids: A Randomized, Noninferiority Trial.

Dis Colon Rectum 2018 Nov 26. Epub 2018 Nov 26.

Background: Long-term outcomes and efficacy of partial stapled hemorrhoidopexy are not known.

Objective: The purpose of this study was to compare the long-term clinical efficacy and safety of partial stapled hemorrhoidopexy with circumferential stapled hemorrhoidopexy.

Design: This was a parallel group, randomized, noninferiority clinical trial. Read More

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November 2018
1 Read

[Comprehensive analysis of unplanned reoperations in colorectal cancer surgery].

Zhonghua Zhong Liu Za Zhi 2018 Nov;40(11):837-840

Medical Service Department, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.

To investigate the causes and impacts of unplanned reoperations (UO) in patients underwent colorectal cancer surgery, and its effect on the length of hospital stays and hospitalization fees of these patients. we retrospectively analyzed the data of colorectal tumor patients underwent resection and UO from January 2014 to November 2017 in Cancer Hospital, Chinese Academy of Medical Sciences (CAMS). Student t tests, ANOVA analysis and chi-square test were used to compare the paired data and data of multiple groups, respectively. Read More

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November 2018
2 Reads

First Aid Toolkit for Anal Fistulas, a Detailed Treatise for Trainees (Video Vignette ESCP Trainee Video).

Colorectal Dis 2018 Nov 24. Epub 2018 Nov 24.

ETZ Hospital, Tilburg, The Netherlands.

Fistula surgery is often performed by trainees. However, an inexperienced trainee may lay open a fistula that could be treated by a more conservative approach. There is considerable national and international variation and the present video will not attempt to define superior methods, but rather highlight matters of debate. Read More

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November 2018
10 Reads

Treatment of Perianal Sepsis, a Detailed Treatise for Trainees (Video Vignette ESCP Trainee Video).

Colorectal Dis 2018 Nov 24. Epub 2018 Nov 24.

ETZ Hospital, Tilburg, The Netherlands.

For many surgeons, the drainage of a perianal abscess is the first operation they perform unsupervised. However, this risks an adverse outcome if the young surgeon has not been well trained. Most surgeons believe perianal sepsis is caused by cryptoglandular infection. Read More

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November 2018
7 Reads

Diverting stoma-related complications following colorectal endometriosis surgery: a 163-patient cohort.

Eur J Obstet Gynecol Reprod Biol 2018 Nov 6;232:46-53. Epub 2018 Nov 6.

Expert Center in the Diagnosis and Multidisciplinary Management of Endometriosis, Rouen University Hospital, Rouen, France; Clinique Tivoli-Ducos, Bordeaux, France. Electronic address:

Objective: Deep endometriosis may simultaneously infiltrate the vagina and the rectosigmoid, which associated resection may increase the risk of postoperative complications. Among these complications, rectovaginal fistula is one of the worst. To reduce the risk of rectovaginal fistula and related complications, surgeons may employ diverting stoma. Read More

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November 2018
4 Reads

Radiofrequency ablation in a patient with radiation enteritis: A case report.

Medicine (Baltimore) 2018 Nov;97(47):e13328

Department of Gastroenterology, Ji'nan Central Hospital Affiliated to Shandong University, Jinan, China.

Rationale: Radiation enteritis (RE) is one of the serious complications caused by the radiotherapy and it can occur in any segment of the intestine, including small intestine, colon, and rectum. It can cause a number of serious problems of the intestine, such as chronic ulcers, bleeding, intestinal stenosis, intestinal fistula, and perforation. At present, there is no standard treatment guideline for the RE. Read More

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November 2018
4 Reads

Systematic review of the applications of three-dimensional printing in colorectal surgery.

Colorectal Dis 2018 Nov 20. Epub 2018 Nov 20.

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

Aim: Three-dimensional (3D) printing has been recognized as a revolutionary technological innovation that has benefitted numerous disciplines, including medicine. The present systematic review aimed to demonstrate the current applications of 3D printing in colorectal surgery along with the limitations and potential future applications of this innovation.

Method: A PRISMA-compliant systematic literature search of studies that applied 3D printing in colorectal surgery in the period from January 1990 to July 2018 was conducted. Read More

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November 2018
6 Reads

Morbidity and Mortality Following Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy: Data from the DGAV StuDoQ Registry with 2149 Consecutive Patients.

Ann Surg Oncol 2018 Nov 19. Epub 2018 Nov 19.

Department of General, Visceral, Vascular and Pediatric Surgery, University Hospital Würzburg, Würzburg, Germany.

Background: Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) are performed for well-selected patients with peritoneal surface malignancies. This combined treatment is potentially associated with an increased rate of complications.

Objective: The aim of this paper was to analyze the morbidity and mortality of CRS and HIPEC in the German national registry. Read More

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November 2018
1 Read

Common Iliac Arterial-Rectal Fistula Managed with Endovascular Stenting in a Patient with History of Pelvic External Beam Radiation.

Am Surg 2018 Apr;84(4):e133-e135

Department of General Surgery, Division of Trauma, Surgery and Critical Care, York Hospital, Wellspan Health, York, Pennsylvania, USA.

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April 2018
3 Reads

Diverting Stoma for Refractory Ano-perineal Crohn's Disease, Is It Really Useful in the Anti-TNF Era? A multivariate analysis in 74 consecutive patients.

J Crohns Colitis 2018 Nov 19. Epub 2018 Nov 19.

Department of Colorectal Surgery, Beaujon Hospital, Assistance Publique-Hôpitaux de Paris, (AP-HP), University Denis Diderot (Paris VII), Clichy, France.

Background & Aims: Faecal diversion (FD) can be proposed in patients with refractory anoperineal Crohn's disease (APCD). This study aimed to assess long-term results of this strategy, following the advent of the anti-TNF era.

Methods: All patients who underwent FD for refractory APCD between 2005 and 2017 were included, excluding patients with a history of ileal pouch-anal anastomosis. Read More

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November 2018
4 Reads

Persistent Fistula After Anorectal Abscess Drainage: Local Experience of 11 Years.

Dis Colon Rectum 2018 Nov 15. Epub 2018 Nov 15.

Fistula Research Unit, St. Mark's Hospital and Academic Institute, Harrow, Middlesex, United Kingdom.

Background: The characteristics of patients who develop a fistula-in-ano after an anorectal abscess are unclear.

Objective: Our study explored this relationship and patient factors associated with fistula development.

Design: International Classification of Diseases, 10 Revision, and Classification of Interventions and Procedures, version 4, codes were used to identify all of the patients with a primary anorectal abscess. Read More

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November 2018
6 Reads

The rectal remnant after total colectomy for colitis - intra-operative,post-operative and longer-term considerations.

Scand J Gastroenterol 2018 Nov 18:1-10. Epub 2018 Nov 18.

a Department of Colorectal Surgery , Oxford University Hospital NHS Foundation Trust , Oxford , UK.

Objectives: Acute severe colitis requires surgery in around 30% of the cases. Total colectomy with ileostomy is the standard procedure with distinct advantages to a laparoscopic approach. Less agreement exists regarding the formation or configuration of the retained rectal stump and its short-term and long-term management. Read More

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November 2018
2 Reads

Vestibulo-Rectal Pull Through in H-Fistula in Girls.

J Indian Assoc Pediatr Surg 2018 Oct-Dec;23(4):182-185

Department of Pediatric Surgery, Park Medical Research and Welfare Society, Kolkata, West Bengal, India.

Aims And Objectives: Vestibulo-rectal pull-through (VRPT) in H-fistula in girls was first described by Chatterjee . We are presenting our experience with this approach in 47 cases.

Materials And Methods: We have total 47 cases of which one is a recurrent fistula operated outside. Read More

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November 2018
3 Reads

Clinical Outcomes of a Redo for a Failed Colorectal or Coloanal Anastomosis.

Ann Coloproctol 2018 Oct 31;34(5):259-265. Epub 2018 Oct 31.

Colorectal Cancer Center, Kyungpook National University Medical Center, School of Medicine, Kyungpook National University, Daegu, Korea.

Purpose: Redo surgery in patients with a persistent anastomotic failure (PAF) is a rare procedure, and data about this procedure are lacking. This study aimed to evaluate the surgical outcomes of redo surgery in such patients.

Methods: Patients who underwent a redo anastomosis for PAF from January 2004 to November 2016 were retrospectively evaluated. Read More

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October 2018
7 Reads

Systematic review of single-incision versus conventional multiport laparoscopic surgery for sigmoid colon and rectal cancer.

World J Surg Oncol 2018 Nov 10;16(1):220. Epub 2018 Nov 10.

Department of Colorectal Surgery, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, No 44 Xiaoheyan Road, Dadong District, Shenyang, 110042, Liaoning Province, People's Republic of China.

Objectives: To explore whether single-incision laparoscopic surgery (SILS) has the better short-term clinical and pathological outcomes than conventional multiport laparoscopic surgery (CLS) for sigmoid colon and rectal cancer.

Methods: A literature investigation of MEDLINE, PubMed, Ovid, Embase, Cochrane Library, Web of Science, Chinese National Knowledge Infrastructure (CNKI), Chinese Biological Medicine (CBM), and Wanfang databases for relevant researches was performed. Fixed effects and random effects models were used to calculate the corresponding outcomes. Read More

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November 2018
6 Reads

Efficacy of irrigation tubes in the management of para rectal cavities associated with complex fistula-in-ano.

BMC Surg 2018 Nov 9;18(1):95. Epub 2018 Nov 9.

Department of Surgery, Faculty of Medicine, University of Colombo, P.O. Box 271, Kynsey Road, Colombo 8, Western Province, Sri Lanka.

Background: Surgical management of complex perianal fistula associated with pararectal cavities can be challenging. We hypothesised that healing of the pararectal cavities prior to healing of the fistula leads to a better outcome. We aimed to assess the efficacy of irrigation catheters in the healing of pararectal cavities associated with fistula-in-ano. Read More

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November 2018
4 Reads

Is it Possible to Successfully Treat Locally Advanced Colon Cancer Using Pre-Operative Chemoradiotherapy?

Clin Endosc 2018 Nov 9. Epub 2018 Nov 9.

Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea.

Pre-operative chemoradiotherapy (CRT) is a preferable treatment option for patients with locally advanced rectal cancer. However, few data are available regarding pre-operative CRT for locally advanced colon cancer. Here, we describe two cases of successful treatment with pre-operative CRT and establish evidence supporting this treatment option in patients with locally advanced colon cancer. Read More

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November 2018
2 Reads

Congenital anal atresia with rectovestibular fistula, scoliosis, unilateral renal agenesis, and finger defect (VACTERL association) in a patient with partial bicornuate uterus and distal vaginal atresia: A case report.

Medicine (Baltimore) 2018 Nov;97(45):e12822

Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, P. R. of China.

Rationale: Vertebral defect, anal atresia, cardiac defect, tracheoesophageal fistula/esophageal atresia, renal defect, and limb defect (VACTERL) association and Müllerian duct anomalies are rare conditions. We present a rare condition with the co-occurrence of the VACTERL association and Müllerian duct hypoplasia to characterize patients' clinical presentations, outcomes, and treatment.

Patient Concerns: An 11-year-old girl presented to our hospital with severe lower abdominal pain, lower vaginal atresia with enlargement of the upper vagina and a bicornuate uterus with a Y-shaped uterine cavity filled with hematometra on pelvic magnetic resonance imaging. Read More

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November 2018
7 Reads

Consequences of Increasing Complexity in Anorectal Surgery Performed at an Academic Center.

Dis Colon Rectum 2018 Nov 1. Epub 2018 Nov 1.

Background: Anorectal surgery encompasses a wide range of procedures with varying complexity. The Accreditation Council for Graduate Medical Education Review Committee for Colon and Rectal Surgery recommends minimum case numbers (60) for 1-year specialty trainees in 6 categories of anorectal surgery, with definitions for procedural complexity.

Objective: The purpose of this study was to assess the scope of anorectal procedures and propose a stratification of procedures based on a consensus of levels of difficulty, as well as to identify a predictive charge cutoff suggestive of procedural complexity. Read More

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November 2018
4 Reads

Transition of care: a growing concern in adult patients born with colorectal anomalies.

Pediatr Surg Int 2018 Nov 3. Epub 2018 Nov 3.

Department of Pediatric Surgery, International Center for Colorectal and Urogenital Care, Children's Hospital Colorado, University of Colorado, 13123 East 16th Avenue, Anschutz Medical Campus, Box 323, Aurora, CO, 80045, USA.

Purpose: Traditionally, the care of children and adults has been arbitrarily separated into pediatric and adult medicine and surgery. Despite progress in pediatric surgical techniques, patients born with congenital anomalies still suffer from significant functional sequelae, which persist into adulthood. We aim to describe some of the most common problems experienced by adult patients with congenital colorectal malformations. Read More

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November 2018
7 Reads

Rectothecal fistula complicating anterior sacral meningocele repair.

Radiol Case Rep 2019 Jan 26;14(1):112-115. Epub 2018 Oct 26.

Department of Radiology, University of Washington, 1959 NE Pacific St, Seattle, WA 98195, USA.

We present a case of an iatrogenic rectothecal fistula in a 34-year-old man who underwent repair of a congenital anterior sacral meningocele, intraoperatively complicated by rectal perforation. Postoperatively, the patient developed symptoms of meningitis prompting concern for the cerebrospinal fluid leak. Subsequent workup with computed tomography (CT) and magnetic resonance imaging demonstrated a postoperative pseudomeningocele and fistulization with an abdominal fluid collection. Read More

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January 2019
2 Reads

[Definition, epidemiology and risk factors of obstetric anal sphincter injuries: CNGOF Perineal Prevention and Protection in Obstetrics Guidelines].

Gynecol Obstet Fertil Senol 2018 Oct 29. Epub 2018 Oct 29.

Service de gynécologie-obstétrique, hôpitaux de Nantes, CHU Hôtel-Dieu, 38, boulevard Jean-Monnet, 44000 Nantes, France; Université de Nantes, 1, rue Gaston-Veil, 44000 Nantes, France.

Objectives: The aim of this review was to agree on a definition of the obstetric anal sphincter injuries (OASIS), to determine the prevalence and risk factors.

Methods: A comprehensive review of the literature on the obstetric anal sphincter injuries (OASIS), establishment of levels of evidence (NP), and grades of recommendation according to the methodology of the recommendations for clinical practice.

Results: To classify obstetric anal sphincter injuries (OASIS), we have used the WHO-RCOG classification, which lists 4 degrees of severity. Read More

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October 2018
5 Reads

Update on the Natural Course of Fistulizing Perianal Crohn's Disease in a Population-Based Cohort.

Inflamm Bowel Dis 2018 Oct 19. Epub 2018 Oct 19.

Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota.

Background: This study sought to re-estimate the cumulative incidence of perianal or rectovaginal fistulas and the associated proctectomy rate in the prebiologic era vs the biologic era using a population-based cohort of Crohn's disease (CD) patients.

Methods: The medical records of 414 residents of Olmsted County, Minnesota, who were diagnosed with CD between 1970 and 2010 were reviewed. The cumulative incidence of perianal or rectovaginal fistulas from time of CD diagnosis and the cumulative rate of proctectomy from date of first perianal or rectovaginal fistula diagnosis were estimated using the Kaplan-Meier method. Read More

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October 2018
1 Read

Corrigendum: Man with a swollen mass on sacrococcygeal region.

Pan Afr Med J 2018 28;30:60. Epub 2018 May 28.

Dermatology Division, Department of Medical Clinics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil.

[This corrects the article DOI: 10.11604/pamj.2018. Read More

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High ligation of the anal fistula tract by lateral approach: A prospective cohort study on a modification of the ligation of the intersphincteric fistula tract (LIFT) technique.

Int J Surg 2018 Oct 19;60:9-14. Epub 2018 Oct 19.

Department of Coloproctology, Yang Hospital, Seoul, Republic of Korea.

Background: Ligation of the intersphincteric fistula tract (LIFT) is a sphincter-preserving operation for anal fistulas. Although it has advantages in preserving continence after surgery, it is difficult to perform owing to the narrow field of view. We performed a modified surgical procedure based on the LIFT to overcome these drawbacks. Read More

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October 2018
63 Reads

Permacol Collagen Paste Injection for Treatment of Complex Cryptoglandular Anal Fistulas: An Observational Cohort Study With a 2-Year Follow-up.

Surg Innov 2018 Oct 19:1553350618808120. Epub 2018 Oct 19.

1 "S. Maria dei Battuti" Hospital, Conegliano (TV), Italy.

Background: Permacol paste injection is a novel treatment approach for complex cryptoglandular anal fistulas. This study was performed to evaluate the long-term clinical outcomes of treatment with Permacol paste for complex cryptoglandular fistulas.

Methods: Patients with primary or recurrent complex cryptoglandular anal fistulas treated with Permacol paste from 2014 to 2016 were retrospectively analyzed. Read More

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October 2018
1 Read

The Impact of the Outcome of Treating a High Anal Fistula by Using a Cutting Seton and Staged Fistulotomy on Saudi Arabian Patients.

Ann Coloproctol 2018 Oct 10;34(5):234-240. Epub 2018 Oct 10.

Department of General Surgery, Al Ansar General Hospital, Medina, Saudi Arabia.

Purpose: A cutting seton is used after a partial distal fistulotomy to treat patients with a high exrasphincteric fistula in ano to avoid fecal incontinence and recurrence. In Saudi Arabia, religious practices necessitate complete cleanness, which makes conditions affecting anal continence a major concern to patients affected by an anal fistula. Therefore, we aimed to evaluate the efficiency of the cutting seton in treating a high anal fistula among Saudi Arabians. Read More

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October 2018
5 Reads

Endoscopy in inflammatory bowel disease: Role in diagnosis, management, and treatment.

World J Gastroenterol 2018 Sep;24(35):4014-4020

Division of Gastroenterology and Hepatology, University of North Carolina, Charlotte, NC 28204, United States.

Endoscopy plays a fundamental role in the diagnosis, management, and treatment of inflammatory bowel disease (IBD). Colonoscopy, flexible sigmoidoscopy, and esophagogastroduodenoscopy have long been used in the care of patients with IBD. As endoscopic technologies have progressed, tools such as endoscopic ultrasound, capsule endoscopy, and balloon-assisted enteroscopy have expanded the role of endoscopy in IBD. Read More

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September 2018
10 Reads

Laparoscopic Surgery for Diverticular Fistulas: Outcomes of 111 Consecutive Cases at a Single Institution.

J Gastrointest Surg 2018 Sep 24. Epub 2018 Sep 24.

Division of Surgery, Section of Colon and Rectal Surgery, Albany Medical Center, 47 New Scotland Avenue, MC-61, Albany, NY, 12208, USA.

Background: The purpose of this study was to review our experience with laparoscopic colectomy and fistula resection, evaluate the frequency of conversion to open, and to compare the perioperative courses of the complete laparoscopic and conversion groups.

Methods: This study is a retrospective analysis of 111 consecutive adult patients with diverticular fistulae diagnosed clinically or radiographically over 11 years at a single institution. Five patients were excluded for preoperative comorbidities. Read More

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September 2018
14 Reads

Ligation of intersphincteric fistula tract procedure for the treatment of fistula in ano - a video vignette.

Colorectal Dis 2018 Dec 9;20(12):1154. Epub 2018 Oct 9.

Department of Surgery, Aarhus University Hospital, Aarhus, Denmark.

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December 2018
1 Read

Suprapubic single-port approach for complicated diverticulitis.

Tech Coloproctol 2018 09 15;22(9):657-662. Epub 2018 Sep 15.

Colon and Rectal Surgery Division, Humanitas Clinical and Research Center, Via Alessandro Manzoni, 56, 20089, Rozzano, Milan, Italy.

Background: Laparoscopic sigmoidectomy is the gold standard for elective surgical treatment of diverticulitis. A periumbilical single-port technique reduces the size of the access wound, usually to 3-4 cm. However, in the presence of large phlegmon or fistulae, the risk of conversion is higher and the extraction site might be enlarged. Read More

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September 2018
7 Reads

Coloseminal vesicle fistula after low anterior resection: Report of a case and review of the literature.

Int J Surg Case Rep 2018 31;51:257-260. Epub 2018 Aug 31.

Division of Colorectal Surgery, St-François d'Assise Hospital, CHU de Québec, 10 rue de l'Espinay, Quebec, Quebec, G1L 3L5, Canada.

Introduction: A rectoseminal vesicle fistula after a low anterior resection for rectal cancer is a rare complication despite their anatomic proximity. From a Medline search from 1966 to date, a total of twenty-one previous cases of coloseminal vesicle fistula have been reported. From these cases, eleven were a complication of laparoscopic low anterior resection for rectal cancer. Read More

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August 2018
9 Reads

Human Amniotic Membrane Effect on Perianal Fistula Healing in Rabbits: An Experimental Study.

Iran J Med Sci 2018 Sep;43(5):473-478

Department of Pathology, Shiraz University of Medical Sciences, Shiraz, Iran.

Background: Perianal fistula is a complicated disorder and most difficult to manage. New treatment methods would help surgeons to achieve a better outcome in patients with perianal fistula. Human amniotic membrane (HAM) has positive effects on wound healing in several conditions. Read More

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September 2018
1 Read

Imaging and Surgical Management of Anorectal Vaginal Fistulas.

Radiographics 2018 Sep-Oct;38(5):1385-1401

From the Department of Radiology (W.M.V., S.P.S., M.C.W., J.G.F.), Department of Surgery (A.L.L.), and School of Medicine (S.T.K.), Mayo Clinic, 200 First St SW, Rochester, MN 55905; and Department of Radiology, Mayo Clinic, Scottsdale, Ariz (C.O.M.).

Anorectal vaginal fistulas (ARVFs) can result in substantial morbidity and potentially embarrassing symptoms in adult women of all ages. Despite having what may be obvious clinical manifestations, the fistulas themselves can be difficult to identify with imaging. MRI is the modality of choice for the diagnosis and characterization of ARVFs. Read More

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December 2018
1 Read

Fistula-tract Laser Closure (FiLaC™) for complex urethroperineal fistula.

Acta Chir Belg 2018 Dec 12;118(6):398-401. Epub 2018 Sep 12.

b Department of Abdominal Surgery , University Hospital of Antwerp , Edegem , Belgium.

Background: Fistula formation in hidradenitis suppurativa follows an uncontrolled infection with subcutaneous tracts leading to 'watering-can' or 'pus-pot' perineum. Closure of this type of fistula implies major surgery and is bound to fail in refractory inflammatory environment. Minimally invasive techniques have become the first line of choice in every type of surgery. Read More

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December 2018
26 Reads

Advancement flap procedure in Crohn and non-Crohn perineal fistulas: a simple surgical approach.

Colorectal Dis 2018 Sep 10. Epub 2018 Sep 10.

Department of Gastroenterology, University Hospital of Rennes, Pontchaillou, France.

Aim: Rectal flap advancement is still a part of therapeutic management of anal fistulas. Data on the outcome of rectal flap advancement in patients with Crohn's disease (CD) is scarce. Our objective was to ascertain rates of failure of rectal flap advancement and to determine predictive factors for failure, with a special focus on CD METHOD: The patients' details, the characteristics of the fistula and the main clinical and therapeutic events were prospectively assessed among patients who underwent rectal flap advancement. Read More

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September 2018
2 Reads

[Seton drainage in sphincter-sparing treatment of rectal fistulas].

Khirurgiia (Mosk) 2018 (8. Vyp. 2):65-72

Ryzhikh State Research Center of Coloproctology of Healthcare Ministry of the Russian Federation, Moscow, Russia.

Sphincter-sparing procedures for rectal fistulas are becoming more popular among coloproctologists. However, the outcomes are not optimal that forces surgeons to seek new approaches in order to improve results. Seton drainage prior to radical stage is one of these methods. Read More

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January 2018
1 Read

Comparison of porcine collagen paste injection and rectal advancement flap for the treatment of complex cryptoglandular anal fistulas: a 2-year follow-up study.

Int J Colorectal Dis 2018 Dec 5;33(12):1723-1731. Epub 2018 Sep 5.

Colorectal and Pelvic Floor Diseases Center, Department of General Surgery, "S. Maria dei Battuti" Hospital, Via Brigata Bisagno 4, 31015, Conegliano, TV, Italy.

Background: Rectal advancement flap is the standard surgical treatment for complex cryptoglandular anal fistulas, while Permacol™ collagen paste is considered an innovative treatment option for anorectal fistulas. This study aimed to compare the clinical outcomes of patients with complex cryptoglandular fistulas treated by endorectal advancement flap versus Permacol™ paste.

Methods: This study was a retrospective analysis of patients with complex cryptoglandular anal fistulas. Read More

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December 2018
2 Reads

Constipation, failure to thrive and recurrent abscesses: getting to the bottom of an unusual complaint.

Arch Dis Child Educ Pract Ed 2018 Sep 3. Epub 2018 Sep 3.

Department of Paediatric Education and Simulation, Royal Belfast Hospital for Sick Children, Belfast, UK.

QUESTION 1: Which procedure may have been most appropriate to offer an initial clue to her diagnosis? Abdominal X-ray. Digital rectal examination. Perianal swab for streptococcal infection. Read More

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September 2018
5 Reads

Non-cutaneous AIDS-associated Kaposi's sarcoma presenting as recurrent rectal abscesses.

BMJ Case Rep 2018 Aug 20;2018. Epub 2018 Aug 20.

Department of Surgery, NYU Langone Hospital-Brooklyn, Brooklyn, New York, USA.

Kaposi's sarcoma is a fatal disease that typically presents with cutaneous manifestations in immunocompromised individuals. There are a small number of documented cases where patients diagnosed with this disease present without cutaneous lesions. We present a 35-year-old man with recurrent rectal abscesses and fistula-in-ano, which required multiple drainage procedures. Read More

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August 2018
14 Reads

Ultrasound imaging of the anorectal malformation during the neonatal period: a comprehensive review.

Jpn J Radiol 2018 Oct 17;36(10):581-591. Epub 2018 Aug 17.

Department of Radiology, Saitama Children's Medical Center, 1-2 Shintoshin, Chuo-ku, Saitama, Saitama, 330-8777, Japan.

Anorectal malformation (ARM) is classified as low, intermediate, or high; accurate diagnosis of the type during the early neonatal period is important to determine the appropriate initial surgical approach. This review assesses the role of ultrasound examination in the classification of ARM during the neonatal period, with a focus on landmarks on the sonogram, the approach used for sonography, and the optimal examination timing. The following three factors on the sonogram are used for the classification: location of the fistula, the distance between the distal rectal pouch and the anal dimple (perineum) (P-P distance), and the relationship between the puborectalis muscle and the distal rectal pouch. Read More

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October 2018
3 Reads

MR Imaging of Perianal Fistulas.

Radiol Clin North Am 2018 Sep 11;56(5):775-789. Epub 2018 Jul 11.

Department of Abdominal Imaging, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA.

In this article, we begin with an introduction of the perianal region anatomy, then review the definition, etiology, epidemiology, and 2 major classification systems of perianal fistulas. The role of MR imaging for assessment of perianal fistulas is mainly discussed. Finally, the medical and surgical treatment principles are reviewed. Read More

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September 2018
1 Read

The midterm outcomes of 1-stage versus 3-stage laparoscopic-assisted anorectoplasty in anorectal malformations with rectoprostatic fistula and rectobulbar fistula: A retrospective cohort study.

Medicine (Baltimore) 2018 Aug;97(32):e11843

Department of Key Laboratory, Capital Institute of Pediatrics, Beijing, China.

The aim of this study was to compare the midterm outcomes of 1-stage and 3-stage surgical procedures to treat anorectal malformations (ARMs) with rectoprostatic and rectobulbar fistula using laparoscopic-assisted anorectoplasty (LAARP).A total of 56 patients with ARMs and rectoprostatic and rectobulbar fistula who underwent LAARP from January 2011 to May 2014 in our institution were included in the study. They were divided into 2 groups according to the stage of procedure. Read More

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August 2018
1 Read

Currarino syndrome: repair of the dysraphic anomalies and resection of the presacral mass in a combined neurosurgical and general surgical approach.

J Neurosurg Pediatr 2018 Aug 10:1-7. Epub 2018 Aug 10.

Department of Paediatric Neurosurgery and.

OBJECTIVE It is well established that Currarino syndrome (CS) may be associated with spinal dysraphism. Here, the authors report on 10 CS patients with dysraphic anomalies who had undergone a combined neurosurgical and general surgical approach to repair the dysraphic anomalies and resect the presacral mass in a single operation. They discuss the spectrum of spinal dysraphism that may coexist in CS in the context of its developmental etiology. Read More

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August 2018
8 Reads

Simulation of Supralevator Abscesses and Complex Fistulas in Cadavers: Pelvic Dissemination and Drainage Routes.

Dis Colon Rectum 2018 09;61(9):1102-1107

Surgical Anatomy Unit, Anatomy and Embryology Department, University of Valencia, Valencia, Spain.

Background: Most perianal abscesses have a cryptoglandular origin, following the pathogenesis described by Parks in 1961. Supralevator abscesses have the most uncommon location. Nevertheless, such pathology results in a high morbidity because of their difficult diagnosis and treatment. Read More

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September 2018
12 Reads

Investigation of the feasibility and safety of single-stage anorectoplasty in neonates with anovestibular fistula.

Pediatr Surg Int 2018 Oct 6;34(10):1117-1120. Epub 2018 Aug 6.

Department of Pediatric Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa, Nagoya, 466-8550, Japan.

Purpose: Anovestibular fistula (AVF) is the most common type of anorectal malformation in females. Delayed anorectoplasty with fistula dilatation is commonly performed during infancy; however, we have been actively performing anorectoplasty in neonates. We report the surgical complications and postoperative defecation function associated with single-stage anorectoplasty performed in neonates. Read More

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October 2018

Histopathologic and immunohistochemical findings in congenital anorectal malformations.

Medicine (Baltimore) 2018 Aug;97(31):e11675

Department of Pediatric Surgery, Capital Institute of Pediatrics.

It remains controversial whether the distal rectal pouch should be either resected or used for reconstruction in anorectoplasty for the treatment of anorectal malformations (ARMs). Hence the aim of this study was to investigate whether ARMs were associated with a global neuromuscular maldevelopment of the terminal rectum specimens.There were 36 cases of ARMs (25 recto-bulbar fistula and 11 recto-prostatic fistula) and 10 healthy controls. Read More

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August 2018
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