To see the other types of publications on this topic, follow the link: Anal fistula.
Journal articles on the topic 'Anal fistula'
Create a spot-on reference in APA, MLA, Chicago, Harvard, and other styles
Consult the top 50 journal articles for your research on the topic 'Anal fistula.'
Next to every source in the list of references, there is an 'Add to bibliography' button. Press on it, and we will generate automatically the bibliographic reference to the chosen work in the citation style you need: APA, MLA, Harvard, Chicago, Vancouver, etc.
You can also download the full text of the academic publication as pdf and read online its abstract whenever available in the metadata.
Browse journal articles on a wide variety of disciplines and organise your bibliography correctly.
1
Atreya, Anshu, Ankit Raikhy, Srinivasa Rao Geddam, Abhishekh Bhartia, and Vishnu Kumar Bhartia. "Video Assisted Anal Fistula Treatment, a Paradigm Shift in the Treatment of Complex Anal Fistulas." Journal of Evidence Based Medicine and Healthcare 8, no. 06 (2021): 313–18. http://dx.doi.org/10.18410/jebmh/2021/61.
Full textAbstract:
BACKGROUND Fistula-in-ano or anal fistulas are documented since ancient times and their management has always been a challenge. Various modalities of treatment are available and newer ones are being added each day. The aim of this retrospective study is to analyse the outcome of the video assisted anal fistula treatment (VAAFT), one of the modalities of treatment for complex anal fistulas done at our centre. METHODS Records of patients who had been treated through VAAFT by single senior consultant surgeon of Minimal Access Surgery unit between April 2013 and March 2019, were collected and analysed. RESULTS Altogether, records of 48 (forty-eight) patients who had undergone VAAFT during the period were analysed. Data revealed that 38 male (79.17 %) and 10 female (20.83 %) patients with mean age of 49.96 ± 12.22 years were operated. Most commonly, trans sphincteric followed by inter sphincteric type of fistulae were encountered. In 3 cases, internal opening couldn’t be visualised. Six patients were documented to have a recurrence within 6 months of the procedure and in the rest were cured except in a small subset of patients who did not follow up. CONCLUSIONS Amongst the wide range of armamentarium available today for the treatment of complex anal fistulas, video assisted anal fistula treatment (VAAFT) is a novel sphincter saving technique. The recurrence rate at our centre was at par with other studies and with zero incontinence rate, however further RCTs are required. KEYWORDS Complex Anal Fistula, Fistula-in-Ano, MEINERO Fistuloscope, VAAFT
2
Tian, Ping, Guanhui Tong, and Weilin Wang. "Application of MRI Images Based on Autoregressive Model Algorithm in Diagnosis and Classification of Anal Fistula Disease." Journal of Medical Imaging and Health Informatics 11, no. 1 (2021): 162–67. http://dx.doi.org/10.1166/jmihi.2021.3429.
Full textAbstract:
Objective: To analyze the accuracy of DWI-MRI combined with conventional MRI sequence in the diagnosis and classification of anal fistula, and to explore its application value. Methods: The clinical and imaging data of 56 patients with anal fistula confirmed by surgery were collected. All patients underwent conventional MR scans (axial T1WI, T2WI and axial, coronary, sagittal T2WI fat suppression) and axial DWI. With the surgical pathology results as the gold standard, the diagnostic compliance rate of anal fistula inside and outside mouth, main fistula, branch fistula, and abscess were observed and relied on both conventional sequence and conventional sequence combined with DWI. At the same time, the patients in this group were classified according to Parks classification of anal fistula, and the results were compared with the surgical results. Results: Fifty-six patients with anal fistula were confirmed to have 7 simple anal fistulas and 49 complicated anal fistulas. According to Parks anal fistula classification, MRI diagnosed 7 cases of intersphincteric fistula, 24 cases of trans sphincteric type fistula, 16 cases of superior sphincteric type fistula, and included 9 cases of rectal vaginal/scrotal fistula into the scope of extra-sphincteric fistula. The overall coincidence rate of scores was 87.5% (49/56). Conclusion: In preoperative MRI examination of anal fistula, compared with relying only on conventional sequences, the combined use of DWI sequences has higher accuracy in displaying the inner, outer and branch fistulas, and provides more detailed images before clinical operation. Anatomical information should be applied as a routine examination sequence for preoperative diagnosis of anal fistula.
3
Zhang, Yuru, Fei Li, Tuanjie Zhao, Feng Cao, Yamin Zheng, and Ang Li. "Video-assisted anal fistula treatment combined with anal fistula plug for treatment of horseshoe anal fistula." Journal of International Medical Research 49, no. 1 (2021): 030006052098052. http://dx.doi.org/10.1177/0300060520980525.
Full textAbstract:
Objective Horseshoe anal fistula is a common anorectal disease, and there is no standard procedure for its treatment. In this study, we performed a modified surgical procedure for the treatment of horseshoe anal fistula and investigated its efficacy and adverse effects. Methods We retrospectively analyzed the outcomes of video-assisted anal fistula treatment combined with an anal fistula plug (VAAFT-Plug) in 26 patients with a horseshoe anal fistula. The follow-up period ranged from 6 to 18 months. Preoperative and postoperative data were collected to analyze the cure rate, anal sphincter function, and incidence of complications. Results The surgeries were successfully performed in all patients, 23 of whom were cured (effective cure rate of 88.46%). Three patients developed recurrence and were cured after traditional surgery. No patients developed severe complications or postoperative anal incontinence. The VAAFT-Plug protocol was performed with a small incision in the fistula that subsequently promoted fistula healing and preserved sphincter function. Conclusion Although randomized controlled trials will be needed to fully validate these findings, our results suggest that VAAFT-Plug represents a promising treatment strategy for horseshoe anal fistulas. This technique preserves normal anal function and achieves satisfactory outcomes in most patients.
4
Song, Yi-Huan, Jian-Ming Qiu, Guan-Gen Yang, Dong Wang, A.-Li Lin, and Kan Xu. "Differential gene expression in patients with anal fistula reveals high levels of prolactin recepetor." Vojnosanitetski pregled 74, no. 5 (2017): 456–62. http://dx.doi.org/10.2298/vsp160210262s.
Full textAbstract:
Background/Aim. There are limited data examining variations in the local expression of inflammatory mediators in anal fistulas where it is anticipated that an improved understanding of the inflammatory milieu might lead to the potential therapeutic option of instillation therapy in complicated cases. The aim of the present study was to examine prolactin receptors (PRLR) as inflammatory markers and to correlate their expression with both the complexity of anal fistulas and the likelihood of fistula recurrence. Methods. Microarray was used to screen the differentially expressed gene profile of anal fistula using anal mucosa samples with hemorrhoids with ageand sex-matched patients as controls and then a prospective analysis of 65 patients was conducted with anal fistulas. PRLR immunohistochemistry was performed to define expression in simple, complex and recurrent anal fistula cases. The quantitative image comparison was performed combining staining intensity with cellular distribution in order to create high and low score PRLR immunohistochemical groupings. Results. A differential expression profile of 190 genes was found. PRLR expression was 2.91 times lower in anal fistula compared with control. Sixty-five patients were assessed (35 simple, 30 complex cases). Simple fistulas showed significantly higher PRLR expression than complex cases with recurrent fistulae showing overall lower PRLR expression than de novo cases (p = 0.001). These findings were reflected in measurable integrated optical density for complex and recurrent cases (complex cases, 8.31 ? 4.91 x 104 vs simple cases, 12.30 ? 6.91 x 104; p < 0.01; recurrent cases, 7.21 ? 3.51 x 104 vs primarily healing cases, 8.31 ? 4.91 x 104; p < 0.05). In univariate regression analysis, low PRLR expression correlated with fistula complexity; a significant independent effect maintained in multivariate analysis odds ratio [(OR) low to high PRLR expression = 9.52; p = 0.001)]. Conclusion. PRLR expression inversely correlates with anal fistula complexity. Further work must define the specificity of this finding and its relationship to other conventional mediators of inflammation.
5
Singh, A., C. Kakkar, A. Bhardwaj, et al. "P218 Development of Magnetic Resonance Imaging based index to differentiate Crohn’s disease associated perianal fistula and cryptoglandular perianal fistula." Journal of Crohn's and Colitis 18, Supplement_1 (2024): i547—i548. http://dx.doi.org/10.1093/ecco-jcc/jjad212.0348.
Full textAbstract:
Abstract Background Magnetic resonance imaging (MRI) is the standard for evaluating perianal fistulae. Perianal fistula can be the first manifestation of CD, and needs to be differentiated from non-CD associated perianal fistula. This study sought to identify the variations in MRI characteristics of perianal fistulas in patients with and without inflammatory bowel disease (IBD), considering the potential implications for treatment decisions. Methods This was a single-center cross-sectional analysis of patients who underwent pelvic MRI for assessment of perianal fistula between January 2021 and June 2022 at Dayanand Medical College and Hospital (DMCH), Ludhiana, India. Patients who underwent dedicated MRI fistula protocol were included. Patients with prior anal resection or anastomosis, anorectal tumor, or equivocal imaging findings that could not be definitely assessed as a fistula were excluded. The following features were assessed: anatomic type of fistula (Parks classification), luminal origin (hour clock position), anal verge distance, signs of acute inflammation, circumference of anus involved by inflammation, presence of rectal inflammation, and abscess. Results Between January 2022 and December 2022, a total of 287 MRI scans were conducted to assess for perianal fistulae. Out of these, 119 MRI scans met the eligibility criteria and 32(26.89%) were associated with an established clinical diagnosis of CD. A higher proportion of females had CD-associated perianal fistula compared to non-CD perianal fistula. A significantly greater percentage of CD-associated perianal fistulas exhibited supra-levator extension, multiple and branched fistula tracts, and ≥2 internal and external openings. Patients with CD had higher prevalence of concurrent perianal abscess, proctitis, anorectal strictures, and a greater number of clock hours of inflamed anal circumference, compared to patients with cryptoglandular fistula. (Table 1) On multivariate logistic regression analysis, female sex, ≥2 internal openings, proctitis and height of the mucosal origin of the fistula from the anal verge &gt;1.85 cm independently predicted the perianal fistula to be associated with CD. We constructed the DMCH index as follows: DMCH index: (3xfemale sex) + (3x≥2 internal openings of the fistula tract) + (6xrectal wall thickening) + (2xheight of mucosal origin of the fistula from anal verge &gt;1.85 cm) The DMCH index greater than 7 identified the perianal fistulae associated with CD with a sensitivity of 84% and specificity of 91% [Area under curve 0.91; 95% CI 0.85-0.97; P&lt; 0.0001].(Figure 1) Conclusion The DMCH index identifies CD associates perianal fistula with a high level of accuracy. These findings require validation and confirmation in independent, multi-reader studies.
6
Dr. Roopa Bhushan and Dr Manish Joshi. "Laser Management for Anal Fistulas: A Prospective study." IAR Journal of Medicine and Surgery Research 2, no. 4 (2021): 7–11. http://dx.doi.org/10.47310/iarjmsr.2021.v02i04.03.
Full textAbstract:
Introduction: Laser treatment for fistula-in-ano, also known as FiLaC (fistula laser closure) or LAFT (laser ablation of fistula tract), has gained increasing attention in the last decade. The procedure consists of delivering laser energy at 360° within the lumen of fistulas by means of a radial fiber which is slowly withdrawn from the external orifice. Material & Methods: The study analysed 40 patients treated for anal fistulae in Sapthagiri Institute of Medical Sciences, Bangalore between November 2020 to June 2021. Fistulae were classified in accordance with the Parks’ classification system, and all patients were preoperatively assessed by clinical examination and proctosigmoidoscopy and classified using three-dimensional (3D) endoanal ultrasonography performed by a sonographer experienced in endoanal ultrasound. Results: Of the 40 patients, 26 were female and 14 were male (overall median age 46 years; range 17–82 years). The median period of follow-up was 11 months, follow up was scheduled in the outpatient at 1 and 2 weeks and 1, 3, 6 and 11 months postoperatively. However, patients were instructed to return to the outpatient at any time should symptoms recur. In the cohort, 39 fistulae (97.5%) were cryptoglandular in origin and 1 (2.5%) were Crohn’s related. 97.5% had previously undergone surgery including abscess drainage and prior fistula operations. The mean number of operations before FiLaC treatment was 2.4 (±1.7) with a range of 1–9 previous operations. Discussion: The use of FILAC for the treatment of anorectal fistula has shown encouraging. The technique is easy to learn and fast to perform, allows exploration of curved paths and any size since the fiber is very flexible and long. The destruction of the epithelialized path and sealing is carried out by laser emission radially 360◦, thereby allowing the application of energy across the path homogeneous in a controlled manner. Conclusion: The FILAC, sphincter preservation minimally invasive surgery in the treatment of anal fistulas, looks promising although prospective and long-term follow-up studies should be conducted.
7
M. E., Shaileshkumar, and Sushanth P. T. "Complex anal fistulae management by combined technique approach: an experience." International Surgery Journal 5, no. 4 (2018): 1454. http://dx.doi.org/10.18203/2349-2902.isj20181129.
Full textAbstract:
Background: The aim of this study is to evaluate our experience in the management of complex anal fistulae by combined technique approach. Ideal surgical treatment for complex anal fistula should aim to eradicate the source of infection and promote healing of the tract, while preserving the sphincters and the mechanism of anal continence. Even with the evolving newer techniques complex anal fistulae have higher rates of recurrence and functional disability as anal incontinence. The requirement of multiple surgeries for recurrence and the newer techniques like anal fistula plug are expensive and will become a burden for patients living in developing countries like ours. Thus, apart from Ligation of Intersphincteric fistula tract, the use of cutting seton is the main surgical method practiced here. This article focuses on the approach to the complex anal fistula management through evidence-based treatment strategies.Methods: Author conducted a prospective study of 35 complex anal fistulae patients undergoing combined technique approach with cutting Seton, Ligation of Intersphincteric Fistula tract and fistulotomy. Results: All patients recovered well with no complications in postoperative period. After 2 years of follow up patients are recurrence free and only 2 patients had partial incontinence with improving trend.Conclusions: The use of cutting Seton in high anal fistula is an effective technique. LIFT technique is good for Transphincteric tracts without previous scarring; it can be easily learned and applied. We can conclude that combined technique was an effective procedure and valid alternative for complex anal fistula management.
8
Mandal, Prodip Kumar, Fayem Chowdhury, Md Kamrul Ahsan, and AKM Al Masud. "Diagnosis of Anorectal Tuberculosis by Polymerase Chain Reaction, GeneXpert And Histopathogenesis in Anal Fistula Patients." Sir Salimullah Medical College Journal 29, no. 2 (2022): 121–23. http://dx.doi.org/10.3329/ssmcj.v29i2.58968.
Full textAbstract:
Background: Association of tuberculosis (TB) with anal fistulas can make its treatment quite difficult. The main challenge is timely detection of TB in anal fistulas and its proper management. There is little data available on diagnosis and management of TB in anal fistulas.
 Objective: To detect TB in fistula-in-ano patients were analyzed in different methods utilized. Methods: It was a prospective study conducted in Department of Colorectal Surgery, Bangabandhu Sheikh Mujib Medical University and Department of Surgery & Pathology, Sir Salimullah Medical College Mitford Hospital, Dhaka. Total 258 cases were included in this study during the period January 2018 to December 2020.The sampling was done for tissue (fistula tract lining) and pus (when available). The detection rate of various tests to detect TB and prevalence rate of TB in simple vs complex fistulae were studied.
 Results: This study shows 84.1% were non TB fistula and 15.9% were TB fistula. Majority were male between non TB fistula and TB fistula which was 87.1% and 85.4% respectively. TB fistulas were more complex than non-tuberculous fistulas (68.3% vs 44.2%) respectively. TB was detected in (7.4%) samples tested by PCR-tissue, 23.6% samples tested by PCR-pus, (1.6%) samples tested with HPE-tissue and 0.8% samples tested by GeneXpert.
 Conclusion: This study shows the detection of TB by polymerase chain-reaction was higher than by histopathology and GeneXpert. Amongst polymerase chain-reaction, pus had a higher detection rate than tissue. TB fistulas were more complex than non-tuberculous fistulas but aggressive diagnosis and meticulous treatment led to comparable overall success rates in both groups.
 Sir Salimullah Med Coll J 2021; 29(2): 121-123
9
Ilkanich, A. Ya, V. V. Darwin, E. A. Krasnov, F. Sh Aliyev, and K. Z. Zubailov. "Surgical treatment of anal fistula." Сибирский научный медицинский журнал 43, no. 5 (2023): 74–84. http://dx.doi.org/10.18699/ssmj20230507.
Full textAbstract:
A fistula of the anus is a chronic inflammatory process in the pararectal cell, intersphincter space and anal crypt with the presence of a formed fistula passage, where the affected anal crypt is the internal opening of the fistula. The urgency of surgical treatment of rectal fistulas is due to unsatisfactory results because of frequent anal incontinence and relapses of the disease. In this regard, most authors emphasize that the treatment of anal fistulas, as before, remains an urgent problem of colorectal surgery, and the search for new methods is a priority task of colorectal surgery. Literature analysis performed using the Elsevier, PubMed, eLIBRARY.RU, CyberLeninka, Google Scholar databases showed that the currently used technologies and methods of surgical treatment of anal fistulas do not allow us to determine their “gold standard”. In this regard, further analysis of the effectiveness and safety of their use, an assessment of the complications of surgical intervention and the frequency of relapses of the disease is necessary.
10
Jat, Hari Ram, Neel Patel, Sitaram Barath, and Pooja Yadav. "Role of MRI in the Diagnosis and Pre-Operative Classification of Perianal and Anal Fistulas - A Cross-Sectional Study, Southern Rajasthan." Journal of Evidence Based Medicine and Healthcare 8, no. 33 (2021): 3156–62. http://dx.doi.org/10.18410/jebmh/2021/574.
Full textAbstract:
BACKGROUND Perianal fistulas account for a substantial discomfort and morbidity to the patient thus affecting productive man hours and quality of life. Accurate pre-operative assessment of course of the primary fistulous track and secondary extension or abscesses is required for successful surgical management of anal fistulas. The purpose of this study was to diagnose and classify pre-operative perianal fistulas. METHODS This is a cross-sectional study at Department of Radiodiagnosis in a tertiary level hospital of southern Rajasthan from November 2018 to November 2020. The study included a total of 50 patients referred to department of radiology for magnetic resonance imaging (MRI). Statistical analysis was done using chi square test and student t test. RESULTS Out of these patients, 56 % were having secondary tract on MRI, 12 % patients were having abscess and 4 % were having horseshoe abscess on MRI. The commonest type of ano-rectal fistula encountered in the study was Grade -II seen in 32 %. CONCLUSIONS MRI is a highly accurate, rapid and non-invasive tool in pre-operative evaluation of the perianal and anal fistulas. MRI evaluation and classification of perianal fistulae has a high degree of diagnostic accuracy. The use of MRI for the diagnosis and classification of perianal fistula can provide reliable information which has both pre-operative and prognostic value. St James University Hospital classification, which is an MR imaging-based grading system for perianal fistula is very useful for effective radiological-surgical communication thus contributing to improved patient care and reduced rate of recurrence. KEYWORDS MR Fistulogram, Perianal Fistula, Anal Fistula, Fistula Classification, Fistulography
11
Rohit, Dushyant Kumar, Sarvesh Jain, and Grishmraj Pandey. "Effectiveness of ligation of intersphincteric fistula tract (LIFT) in the management of fistulas in ano." International Surgery Journal 4, no. 12 (2017): 3951. http://dx.doi.org/10.18203/2349-2902.isj20175158.
Full textAbstract:
Background: Fistula in ano is an abnormal connection between the epithelized surface of anal canal and usually the perianal skin. It is a benign treatable lesion of rectum and anal canal. Crypto glandular infection accounts for about ninety percent of the cases. The estimated prevalence of an anal fistula is 12 to 28/1000000 of the population per year with male to female ratio 1.8:1. Ligation of intersphincteric fistula tract is a new sphincter saving method with good result in the management of anal fistula. The aim of study was to evaluate the effectiveness and functional outcomes of the ligation of intersphinteric fistula tract (LIFT).Methods: This prospective study includes sixteen patients who were operated for fistulas in ano at Bundelkhand Medical College and Associated Hospital, Sagar from January 2015 to June 2017. Patients above the age of 20 years, proved cases of fistulas in ano without co-morbid conditions and no previous surgical intervention were included in the study. Patients presenting with fistulas from another source such as crohn’s disease, tuberculosis, anal cancer and recurrent fistulas were excluded. A detailed history, clinical presentation, digital rectal examination, anal ultrasound and routine investigations were done in all cases.Results: In the present study most of the patients were male and presents with perianal discharge. The diagnosis is made by clinical history, per rectal examination and anal ultrasonography. All the sixteen patients with fistula in ano underwent ligation of intersphincteric fistula tract (LIFT). The patients were followed for a period of three months. Most of the cases (87.5%) healed within 4-6 weeks. The recurrence of fistula occurs in four cases (25%). Recurrence is due to infection and technical error in the procedures. There were no deaths in the study.Conclusions: The LIFT technique proved to be safe and effective in the treatment of fistula in ano.
12
Sagban, Nabeel J. "loose Seton in management of high anal fistula." Journal of the Faculty of Medicine Baghdad 57, no. 2 (2015): 106–8. http://dx.doi.org/10.32007/jfacmedbagdad.572332.
Full textAbstract:
Background: The treatment of high anal fistulae needs to meet a balance of cure and continence. There are many surgical treatment options available for high fistula-in-ano. The best surgical operation for high anal fistulas is difficult to define because they have varying cure and incontinence rates. A loose Seton is a loop of flexible material (silastic tube, silk, and nylon) placed through the fistulous track to allow drainage by keeping the external skin opening patent. Some surgeons use the loose Seton to allow drainage and others believe that it promotes healing by inducing fibrosisObjective: To check the efficacy of loose Seton in the management of high anal fistulas.Patient and method: A prospective study of 26 patients with high anal fistula managed by loose Seton placement between February- 2009 and February-2010 in 3rd surgical unit, fifth floor, Baghdad teaching Hospital The seton is removed after 3 months in outpatient clinic, follow up for 6 months.Results: Out of 26 patients, 23 were males and 3 were females, the male to female ratio was 7.7:1. Peak occurrence was noted between 30 to 40 years. Minor incontinence was noted in two patients, those patients lost control of flatus which persisted for 4 months. No fecal incontinence noticed in any patient. .In 21 patient the fistulas were successfully eliminated (Success rate =81%) by loose Seton treatment alone, while fistula recurs in five patients (Failure rate =19%).Conclusion: The use of one stage loose Seton is safe and effective in the treatment of high anal fistula.
13
Amirova, A. Kh, S. A. Frolov, A. Yu Titov, et al. "Microbiota of anal fistulas." Hirurg (Surgeon), no. 6 (December 15, 2023): 36–42. http://dx.doi.org/10.33920/med-15-2306-06.
Full textAbstract:
AIM: to evaluate microbiota of anal fistulas. The discharge of fistula track was taken in 54 patients with transsphincter anal fistulas before surgery. The microbiology was carried out using an extended range of culture medium with incubation in aerobic, anaerobic and microaerophilic environment to extract the maximum possible number of microbes. One hundred sixty strains of microbes have been isolated in 54 cases: gram positive bacteria — in 109 (68.4 %) cases and gram-negative bacteria — in 49 (30.4 %). Yeast fungi were detected in 2 (1.2 %) cases. CONCLUSION: qualitative microbiological composition of the anal fistula discharge is similar to perianal abscess.
14
Afzal, Muhammad, Muhammad Junaid Shah, Mujeeb Alam Khan, and Aftab Ullah. "Frequency of Healing of Fistula in Patients Undergoing Video Assisted Anal Fistula Treatment in High Lying Fistula in Ano." Pakistan Journal of Medical and Health Sciences 16, no. 11 (2022): 172–73. http://dx.doi.org/10.53350/pjmhs20221611172.
Full textAbstract:
Background: Fistula-in-ano is an abnormal tract that usually connects rectal mucosa and perianal skin thus accounting upto 90% cases with an incidence of 5.6/100.000 in women while 12.3/100.000 in men. Aim: To determine the frequency of healing in patients with high lying fistlua in ano undergoing VAAFT. Study design: Cross-sectional study. Methodology: Patients (n=153) were enrolled during study. All enrolled patients had DRE and proctoscopy before start of treatment. Fistuloscope was used to diagnose high lying fistula during examination. Metronidazole antibiotic was given to all patients both pre and post-surgery. SPSS v.26 analyzed the data. Stratification of healing data was done with respect to age and gender. Post stratification Chi-Squire test was applied with P-value ≤0.05 was taken as significant. Results: Almost 77% were males while rest (23%) patients were females. Results showed healing in 70% of patients while 30% patients failed to heal. Practical Implication: This study showed that VAAFT procedure is safe as a treatment modality in comparison to Anal Fistula Plug and conventional Seton placement for complex fistulas or high anal fistulas thus advocated sphincter saving procedure in our setups. Conclusion: It was concluded that this new surgical technique has advantages like sphincter-saving with small surgical wounds. However, fistuloscopy identifies secondary tracts or chronic abscesses. Keywords: Healing, High Lying Fistlua and VAAFT.
15
Duran Y, Polat IF, Gokce H, et al. "Interventional treatment of Anal Fistula: A Retrospective Analysis." World Journal of Advanced Research and Reviews 10, no. 2 (2021): 225–28. http://dx.doi.org/10.30574/wjarr.2021.10.2.0171.
Full textAbstract:
Introduction: Anal fistula is a benign anorectal disease. Infection of Hermann and Desfosses anal glands is responsible for the formation of abscesses and/or fistulas. The main treatment is surgery but recurrence and sometimes incontinence are frequently observed. So to choose surgical methods of anal fistula treatment is very important. Aim: The aim of this retrospective study was to evaluate the reliability and feasibility of Video-assisted anal fistula treatment (VAAFT) at the anal fistula surgery. Materials and Methods: A retrospective analysis was performed on data collected during a 11-year period (2008-2019) from 52 patients who underwent fistulotomy with loose seton technique. The male to female ratio was 3:1 and the mean patient age was 48.34 years. Results: Mortality, recurrence, complications rate were 0%. Though the patients were scheduled as day-surgery cases, the average duration of hospital stay was 1.18 days. Quality of life index (QOLI) for these patients were often be improved by treating their fistula. Conclusion: The appropriate treatment for anal fistula is dependent upon the anatomy and the location of the fistula tract. Detection of the inner mouth is the touchstone in the treatment of anal fistula. It could be determined location of inner mouth of the anal fistula easily with transparent anoscope guideline. VAAFT seems to be a safe and effective technique for treating perianal fistula without recurrence and anal incontinence.
16
Peng, Yunhua, Hong Lu, Wei Zhang, et al. "The investigation of serum protein profiles in anal fistula for potential biomarkers." LaboratoriumsMedizin 46, no. 1 (2021): 39–49. http://dx.doi.org/10.1515/labmed-2021-0025.
Full textAbstract:
Abstract Objectives An anal fistula is an external abnormal anatomical connection between the rectum and the outer skin of the anus. Symptoms include anorectal pain, abscesses, perianal cellulitis, smelly or bloody drainage of pus, and, in some cases, difficulty controlling bowel movements. Diagnosis and evaluation of anal fistulas is crucial for prognosis and for the choice of the treatment method. In this study, we aimed to discover potential biomarkers from serum proteins for the prediction of anal fistulas. Methods Using antibody array technology, the expression of 40 proteins was simultaneously detected in serum samples from 13 patients with anal fistulas with chronic diarrhea, 14 patients with chronic diarrhea and six healthy volunteers. Differentially expressed proteins were subsequently validated by ELISA, with a sample population expanded to 30 patients with anal fistulas and chronic diarrhea, 30 patients with chronic diarrheas only and 20 healthy controls. Results Quantification analysis identified MIP-1α, MIP-1β and TNF-R1 with significant differential expression between the anal fistula with chronic diarrhea, chronic diarrhea only and healthy control groups. Bioinformatics analyses, including PCA and heat map creation, showed a clear separation between the three groups using the expression of MIP-1α, MIP-1β and TNF-R1. Validation by ELISA with the expanded sample population fistulas showed significant differential expression levels of MIP-1α, MIP-1β and TNF-R1, displaying accuracy rates of 0.898, 0.987 and 1.0 between the anal fistula with chronic diarrhea and healthy control groups. Accuracy rates between the anal fistula with chronic diarrhea and the chronic diarrhea only groups were 0.9768, 0.909 and 0.964, respectively. Conclusions These results suggest the feasibility of employing serum proteins MIP-1α, MIP-1β and TNF-R1 as potential biomarkers for rapid and convenient diagnosis of anal fistula in chronic diarrhea patients.
17
Darrien, JH, and H. Kasem. "Successful closure of gastrocutaneous fistulas using the Surgisis® anal fistula plug." Annals of The Royal College of Surgeons of England 96, no. 4 (2014): 271–74. http://dx.doi.org/10.1308/003588414x13814021677755.
Full textAbstract:
Introduction Gastrocutaneous fistulas remain an uncommon complication of upper gastrointestinal surgery. Less common but equally problematic are gastrocutaneous fistulas secondary to non-healing gastrostomies. Both are associated with considerable morbidity and mortality. Surgical repair remains the gold standard of care. For those unfit for surgical intervention, results from conservative management can be disappointing. We describe a case series of seven patients with gastrocutaneous fistulas who were unfit for surgical intervention. These patients were managed successfully in a minimally invasive manner using the Surgisis® (Cook Surgical, Bloomington, IN, US) anal fistula plug. Methods Between September 2008 and January 2009, seven patients with gastrocutaneous fistulas presented to Wishaw General Hospital. Four gastrocutaneous fistulas represented non-healing gastrostomies, two followed an anastomotic leak after an oesophagectomy and one following an anastomotic leak after a distal gastrectomy. All patients had poor nutritional reserve with no other identifiable reason for failure to heal. All were deemed unfit for surgical intervention. Five gastrocutaneous fistulas were closed successfully using the Surgisis® anal fistula plug positioned directly into the fistula tract under local anaesthesia and two gastrocutaneous fistulas were closed successfully using the Surgisis® anal fistula positioned endoscopically using a rendezvous technique. Results For the five patients with gastrocutaneous fistulas closed directly under local anaesthesia, oral alimentation was reinstated immediately. Fistula output ceased on day 12 with complete epithelialisation occurring at a median of day 26. For the two gastrocutaneous fistulas closed endoscopically using the rendezvous technique, oral alimentation was reinstated on day 5 with immediate cessation of fistula output. Follow-up upper gastrointestinal endoscopy confirmed re-epithelialisation at eight weeks. In none of the cases has there been fistula recurrence (range of follow-up duration: 30–59 months). Conclusions Surgisis® anal fistula plugs can be used safely and effectively to close gastrocutaneous fistulas in a minimally invasive manner in patients unfit for surgical intervention.
18
ARAÚJO, Sérgio Eduardo Alonso, Marcelli Tainah MARCANTE, Carlos Ramon Siveira MENDES, et al. "INTERESFINCTERIAL LIGATION OF FISTULA TRACT (LIFT) FOR PATIENTS WITH ANAL FISTULAS: A BRAZILIAN BI-INSTITUTIONAL EXPERIENCE." ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) 30, no. 4 (2017): 235–38. http://dx.doi.org/10.1590/0102-6720201700040002.
Full textAbstract:
ABSTRACT Background : The best treatment for anal fistula should extirpate infection and promote healing of the tract, whilst preserving the anal sphincter complex and full continence. Aim: To analyze the success rate after a modified technique for ligation of the intersphincteric fistula tract (LIFT) for patients with anal fistulas. Methods: A prospective (observational cohort study) Brazilian bi-institutional experience with a modified (ligation of the intersphincteric fistula tract without excision) LIFT technique was undertaken. A clinical database was settled for the following variables: age, gender, BMI, comorbidities, distance between external orifice and the anus, previous fistula surgery, type of fistula, operative time, intra- and postoperative complications, duration of follow-up, and success rate. Results: Between November 2015 and January 2017, 38 patients with transsphincteric fistulas were operated on using the modified LIFT procedure. Seventeen (44.7%) were men. Median age was 41 (18-67) years. Median BMI was 26.4 (22-38) kg/m2. Five (13.2%) had undergone previous surgery. The fistula was transsphincteric in all cases. Median follow-up was 32 (range, 14-56) weeks. Success was observed in 30 (79%) patients. Conclusions: The LIFT technique without excision of the fistula tract proved to be safe and effective for transsphincteric anal fistulas.
19
Handaya, Adeodatus Yuda, and Aditya Rifqi Fauzi. "Combined Fistulotomy and Contralateral Anal Internal Sphincterotomy for Recurrent and Complex Anal Fistula to Prevent Recurrence." Annals of Coloproctology 36, no. 2 (2020): 122–27. http://dx.doi.org/10.3393/ac.2018.11.19.
Full textAbstract:
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. Lateral internal sphincterotomy is the usual procedure performed on an anal fissure to decrease the anal sphincter tone. This study reports a combination of fistulotomy and contralateral internal sphincterotomy procedures for recurrent and complex perianal fistula to prevent recurrence. Here, we report 5 cases of recurrent and complex perianal fistula. The combination of fistulotomy and contralateral internal sphincterotomy is a relatively easy and safe procedure for complex perianal fistulae. In our cases, we found neither recurrence nor postoperative anal incontinence.
20
Younes, Hassan E. A. "Ligation of the intersphincteric fistula tract technique in the treatment of anal fistula." International Surgery Journal 4, no. 5 (2017): 1536. http://dx.doi.org/10.18203/2349-2902.isj20171540.
Full textAbstract:
Background: Management of anal fistula is a challenging issue in surgical practice. No single technique is appropriate for treatment of all types of fistulas. The aim of this study was to evaluate the efficacy and safety of a new sphincter-sparing technique: ligation of the intersphincteric fistula tract (LIFT) for management of anal fistula.Methods: Over a period of 18 months from January 2015 to June 2016 twenty-one patients (12 males and 9 females) with transsphincteric anal fistula were treated with the LIFT procedure. Patients were followed up for at least six months postoperatively for fistula recurrence, rate of wound healing and effect on fecal continence.Results: Fistula healing rate was (90.5%); recurrence rate was 9.5% in the form of down staging to intersphincteric fistulas. Mean time of healing of intersphincteric wound was 32±7.4 days (ranged from 17 to 58 days). Mean time of healing of the external opening wound was 27±5.8 days (ranged from 19 to 56 days). No postoperative changes in fecal continence.Conclusions: LIFT operation is a safe and effective management of transsphincteric anal fistula, this technique has high healing rate with no effect on fecal continence.
21
Gupta, P. J. "Anal fistulotomy using radiowaves - long-term outcome." Acta chirurgica Iugoslavica 55, no. 3 (2008): 115–18. http://dx.doi.org/10.2298/aci0803115g.
Full textAbstract:
OBJECTIVE: The aim of this paper was to analyze the results of treatment of anal fistulas using a radiowave device retrospectively. METHODS: Between 2000 and 2008, 976 patients were operated on for perianal fistula. A Ellman radiowave generator was used to carry out the complete surgical procedure. In the follow-up period 155 patients were lost, remaining 821 patients were analyzed in the study. The mean follow-up time was 6.8 years. Analyzed parameters included: postoperative complications, wound healing time, off work duration, recurrence rate and incidence of anal sphincter dysfunction. Severity of gas and stool incontinence was assessed. RESULTS: In our study, subcutaneous fistula was diagnosed in 28.1%, inter-sphincteric in 39.1%, and trans-sphincteric in 32.8%; supra-sphincteric and extra-sphincteric fistulae were not included in the study. Single-tract fistulas were present in 85.4% and multitract fistulas were present in 14.6%. Postoperative complications were noticed in 1.4% of patients, which included postoperative bleeding, abscess formation, premature approximation of skin edges, prolapse of hemorrhoids and local skin allergic reactions. Postoperative gas and/or stool incontinence was noticed in 3.8%. The recurrence rate was 1.7%. CONCLUSIONS: Radiowave fistulotomy offers short operation time, less postoperative pain, early return to normal activity, and faster healing of the wound. The recurrence rate and continence disturbances are comparable to conventional fistulotomy procedures.
22
Shelygin, Yu A., S. V. Vasiliev, A. V. Veselov, et al. "ANAL FISTULA." Koloproktologia 19, no. 3 (2020): 10–25. http://dx.doi.org/10.33878/2073-7556-2020-19-3-10-25.
Full text
23
Shorthouse, A. J. "Anal Fistula." Journal of the Royal Society of Medicine 87, no. 8 (1994): 491–93. http://dx.doi.org/10.1177/014107689408700824.
Full text
24
Nicholls, John. "Anal fistula." Colorectal Disease 14, no. 5 (2012): 535. http://dx.doi.org/10.1111/j.1463-1318.2012.03025.x.
Full text
25
Iannuzzi, James. "Anal Fistula." Diseases of the Colon & Rectum 53, no. 10 (2010): 1454–55. http://dx.doi.org/10.1007/dcr.0b013e3181eb92ea.
Full text
26
Glen, D. L., and F. Seow-Choen. "Anal fistula." British Journal of Surgery 80, no. 12 (1993): 1626–27. http://dx.doi.org/10.1002/bjs.1800801251.
Full text
27
Seow-Choen, F., and R. J. Nicholls. "Anal fistula." British Journal of Surgery 79, no. 3 (1992): 197–205. http://dx.doi.org/10.1002/bjs.1800790304.
Full text
28
Verma, Rahul Kumar, Suman Yadav, and Ashutosh Kumar Yadav. "A CASE STUDY ON A COMPLEX FISTULA-IN-ANO BY AYURVEDIC MANAGEMENT." International Journal of Research in Ayurveda and Pharmacy 14, no. 4 (2023): 4–7. http://dx.doi.org/10.7897/2277-4343.1404101.
Full textAbstract:
Fistula-in-ano can be a complicated disease to manage. An anal fistula is divided into simple and complex fistula. Managing complex fistula is even more challenging, which typically affects younger people and causes persistent morbidity. It is pertinent to define complex anal fistula. From a practical point of view, a fistula that is difficult to manage has a higher risk of recurrence, poses a greater threat to continence and is classified as a complex fistula. Due to its difficulty in treating medically and surgically, Bhagandara (fistula-in-ano) is one of the eight major disorders classified under Astamahagada in Ayurveda. Ayurvedic surgeons frequently use the effective fistula treatment known as Ksharasutra; however, cutting the passage takes a very long time. As a result, this procedure is now sometimes referred to as partial fistulectomy with Ksharasutra ligation, fibrin glue, fistula plug (FP), Fistula-tract Laser Closure (FiLaC), Seton techniques, video-assisted anal fistula treatment (VAAFT), LIFT (ligation of intersphincteric fistulous tract), and IFTAK (interception of fistulous tract with application of Ksharasutra), also known as window technique, where the Guggulu based Apamarg Ksharasutra is placed. This method shortens the healing time and allows repairing such a complicated fistula-in-ano with little tissue injury. Infected anal crypt, secondary extension and related conditions are the key factors that lead to the recurrence of complex anal fistulas. Surgery in complex anal fistula aims to prevent recurrence, avoid incontinence and avoid damaging the sphincter muscles (the ring of muscles that open and close the anus).
29
Karacan, Erkan, and Eyüp Murat Yılmaz. "Treatment of the fistula tract with laser ablation in high anal fistula." Journal of Clinical Medicine of Kazakhstan 19, no. 6 (2022): 43–45. http://dx.doi.org/10.23950/jcmk/12685.
Full textAbstract:
<b>Aim and introduction:</b> Considering the recurrence and fecal incontinence rates in high anal fistulas, surgical treatment of anal fistulas is a challenging process, although many treatments have been defined today. The aim of our study is to evaluate the long-term results of laser ablation of the fistula tract in high anal fistulas.<br /> <b>Material and methods: </b>The files of patients who underwent laser ablation of the fistula tract due to high anal fistula between June 2020 and January 2022 were evaluated retrospectively. Moreover, their postoperative complications, preoperative and postoperative Cleveland fecal incontinence scores (CCFFSI score), postoperative first day and first-week visual analog scale (VAS) scores, follow-up times, and recurrence rates were analyzed.<br /> <b>Results:</b> 26 patients were included in the study. The mean follow-up period was 39.88±14.34 weeks, and the postoperative first and 7th day VAS scores were 4.61±1.41 and 0.8±1.02, respectively. Preoperative and postoperative CCFI scores were calculated as 1.8±1.41, 1.65±1.32, respectively. Recurrence was observed in 7 patients postoperatively. Postoperative anal abscess developed in 1 patient.<br /> <b>Conclusion: </b>Although laser ablation of the fistula tract can be safely performed as a technique that does not affect incontinence, recurrence rates should also be considered. Furthermore, more extensive randomized prospective studies on this technique should be performed.<b> </b>
30
Kovalev, Sergey, Albert Alibekov, Aleksei Orekhov, et al. "Clinical experience of applying a modified FILaC procedure for treatment of complex anal fistulas." Archiv Euromedica 12, no. 1 (2022): 49–54. http://dx.doi.org/10.35630/2199-885x/2022/12/1.12.
Full textAbstract:
Surgical treatment of complicated anal fistulas remains one of the most difficult issues of coloproctology. In this study we used a modification of Fistula Laser Closure procedure in complex treatment of patients with anal fistulas. The purpose of our study was to assess the short-term and remote results of applying the modified FiLaC procedure in patients with complex anal fistulas and compare these results with conventional fistulectomy. The patients with complex transsphincteric and extrasphincteric anal fistulas were prospectively divided into FiLaC and conventional fistulectomy groups. The operative duration was longer, by 31% (p<0.05), in the FiLaC group compared to the control group. The healing of fistulas was faster by 42% (p<0.05)in the FiLaC group (7.3 ± 0.5 weeks versus 12.6 ± 0.7 weeks). The Wexner Incontinence scale scores were significantly lower (p<0.05) in the FiLaC group. The recurrence of rectal fistula after the surgery was observed in 37.2% in the control group versus 17.5% in the FiLaC group (p<0.05) (median follow up period — 13 months). The pressure parameters of the anal sphincter were significantly higher (p<0.05) in the longterm follow-up period in patients of the FiLaC group and continence was maintained in 92.5% of the FiLaC group. Thus, the study has shown that the modified FiLaC procedure accelerates the healing time of the fistula by 42% (p<0.05), reduces the number of fistula recurrences from 37.2% to 17.5% (p<0.05), and has minimal negative effects on anal continence.
31
Tabry, Helena, and Paul A. Farrands. "Update on Anal Fistulae: Surgical Perspectives for the Gastroenterologist." Canadian Journal of Gastroenterology 25, no. 12 (2011): 675–80. http://dx.doi.org/10.1155/2011/931316.
Full textAbstract:
Anal fistulae are common and debilitating; they are characterized by severe pain and discharge. They arise following infection near the anal canal, or as a primary event from an abscess in the abdomen, fistulating into the vagina or perianal skin. The term ‘cryptoglandular’ is given to abscesses arising from the anal glands.For many years, the treatment of choice was to lay open the fistula; however, this risks causing incontinence with potentially devastating consequences. Alternative surgical treatments include setons, fibrin glue, collagen plugs and flaps to cover the internal fistula opening. These have achieved varying degrees of success, as will be discussed. The present review also discusses anal fistulae in light of much recently published literature. Currently, anal fistulae remain challenging and require specialist expertise; however, new treatment options are on the horizon.
32
Kanikovsky, O. E., and O. S. Yakovenko. "EFFICIENCY OF MRI DIAGNOSTICS IN THE TREATMENT OF ANORECTAL FISTULA." Kharkiv Surgical School, no. 2-3 (June 28, 2024): 172–76. http://dx.doi.org/10.37699/2308-7005.2-3.2024.34.
Full textAbstract:
Abstract. Treatment of anorectal fistulas has many problems that can be minimized with the correct algorithm of action. The size and location of the abscess will affect the length and type of anorectal fistula in the future. With the number of anorectal fistulas, the location of the fistula course in relation to the sphincter apparatus is of particular importance. When the internal opening is lower than 1/3 of the sphincter, the risk of incontinence becomes more than 50 % and this condition may be irreversible. That is why the main task of modern methods of treating anorectal fistulas is to preserve the development of cells of the sphincter apparatus of the anal canal. For the diagnosis of anorectal fistulas, there are such methods as: endoanal 3d ultrasound, MRI, SCT, but the gold standard is MRI. MRI scans provide the most data on pelvic tissue, which allows us to evaluate many parameters when diagnosing anorectal fistulae. The purpose of the study: To evaluate the effectiveness of the use of MRI in the diagnosis of anorectal fistulae. Materials and methods: An analysis of the results of treatment of 34 patients who were treated in the surgical clinic of the Medical Faculty No. 2 of the M.I. Pirogov State Medical University in 2020-2023 was carried out. Results: In the treatment of anorectal fistulas, a clear understanding of the relationship between the fistula, the internal opening and the anal sphincter is a factor. One of the most common causes of relapses is a situation with a missed additional fistula course, which later became the reason for maintaining the preservation and development of a new fistula course. On MRI scans, the duration of the fistula course, the presence of additional expansion of the fistula course, blind pockets with the accumulation of hypo- and hyperechoic inclusions and other things were evaluated. There are several classifications to describe a fistula, the Parkes classification, the St James’s University Hospital (SJUH) classification, which is based specifically on the most common cases of magnetic resonance imaging. Conclusions: 1. MRI studies in the detection of anorectal fistulas appear to be the gold standard. The data obtained during the MRI study do not allow choosing the most optimal treatment tactics to obtain the best result of the treatment of anorectal fistulas.
33
Atroshchenko, A. O., D. O. Kiselev, S. V. Pozdnyakov, A. V. Teterin, and D. L. Davidovich. "Evolution of treatment for rectal fistula: from resection to FiLaC® laser ablation." Pelvic Surgery and Oncology 11, no. 1 (2021): 35–41. http://dx.doi.org/10.17650/2686-9594-2021-11-1-35-41.
Full textAbstract:
Rectal fistula – one of the most common coloproctological diseases. Annually, thousands of patients with anal fistula have had treated around the world. Treatment of this disease is an actual problem in coloproctology nowadays due to the high frequency of recurrence and anal incontinency. The chronic persistent perianal suppuration and multiple surgical interventions the main predictor of emergence of the anal incontinence, which could be achieve almost 50 %, according the literature data. The risk of emergence the anal incontinence is particularly high in the treatment of complex fistulas. Therefore, the problem of complex rectal fistulas treating remains an actual task in the clinical practice of a coloproctologist.
34
Bobkiewicz, Adam, Łukasz Krokowicz, Maciej Borejsza-Wysocki, and Tomasz Banasiewicz. "A novel model of acellular dermal matrix plug for anal fistula treatment. Report of a case and surgical consideration based on first utility in Poland." Polish Journal of Surgery 89, no. 4 (2017): 52–55. http://dx.doi.org/10.5604/01.3001.0010.3912.
Full textAbstract:
Anal fistula (AF) is a pathological connection between anus and skin in its surroundings. The main reason for the formation of anal fistula is a bacterial infection of the glands within the anal crypts. One of the modern techniques for the treatment of fistulas that do not interfere with the sphincters consists in implantation of a plug made from collagen material. We are presenting the first Polish experience with a new model of biomaterial plug for the treatment of anal fistula. We also point out key elements of the procedure (both preoperative and intraoperative) associated with this method. In the authors’ opinion, the method is simple, safe and reproducible. Innovative shape of the plug minimizes the risk of its migration and rotation. It also perfectly blends with and adapts to the course and shape of the fistula canal, allowing it to become incorporated and overgrown with tissue in the fistula canal. The relatively short operation time, minor postoperative pain and faster convalescence are with no doubt additional advantages of the method. Long-term observation involving more patients is essential for evaluation of the efficacy of the treatment of fistulas with the new type of plug.
35
Cheung, FY, ND Appleton, S. Rout, et al. "Video-assisted anal fistula treatment: a high volume unit initial experience." Annals of The Royal College of Surgeons of England 100, no. 1 (2018): 37–41. http://dx.doi.org/10.1308/rcsann.2017.0187.
Full textAbstract:
Introduction Perianal fistulas are a common problem. Video-assisted anal fistula treatment is a new technique for the management of this difficult condition. We describe our initial experience with the technique to facilitate the treatment of established perianal fistulas. Methods We reviewed a prospectively maintained database relating to consecutive patients undergoing video-assisted anal fistula treatment in a single unit. Results Seventy-eight consecutive patients had their perianal fistulas treated with video-assistance from November 2014 to June 2016. Complete follow-up data were available in 74 patients, with median follow-up of 14 months (interquartile range 7–19 months). There were no complications and all patients were treated as day cases. Most patients had recurrent disease, with 57 (77%) having had previous fistula surgery. At follow-up, 60 (81%) patients reported themselves ‘cured’ (asymptomatic) including 5 patients with Crohn’s disease and one who had undergone 10 previous surgical procedures. Logistical stepwise regression did not demonstrate any statistically significant factors that may have been considered to affect outcome (age, gender, diabetes, previous I&D, Crohn’s disease, smoking, type of fistula). Conclusions Our data have shown that video-assisted anal fistula treatment is safe and effective in the management of perianal fistulas in our patients and this suggests it may be applied to all patients regardless of comorbidity, underlying pathology or type of fistula.
36
Herold, A. "Anal Abscess and Anal Fistula." Viszeralchirurgie 40, no. 6 (2005): 425–26. http://dx.doi.org/10.1055/s-2005-918168.
Full text
37
Musin, A. I., E. V. Antipova, A. A. Ulyanov, and D. E. Kuznetsov. "Ligature method for the treatment of anal fistula: a modern view on the old approach (literature review)." Grekov's Bulletin of Surgery 178, no. 2 (2019): 79–84. http://dx.doi.org/10.24884/0042-4625-2019-178-2-79-84.
Full textAbstract:
Despite a thousand-year history of anal fistula treatment, long-term outcomes have not been optimal, which encourages us to explore new surgical approaches. One of the methods of surgical treatment of anal fistulas is the use of ligature (Seton) in its different modifications. This review analyzes the literature data on the use of different modifications of seton treatment of anal fistulas. The analysis of publications showed the great interest in the use of the method, yet there is neither clear scheme nor systematic approach to applying it in clinical practice. Further study, as well as randomized researches, are required to find the optimal treatment and improve surgery results of using seton when dealing with anal fistula.
38
Ratto, Carlo, Angelo Alessandro Marra, Angelo Parello, Veronica De Simone, Paola Campennì, and Francesco Litta. "Would Surgeons Like to Be Submitted to Anal Fistulotomy? An International Web-Based Survey." Journal of Clinical Medicine 12, no. 3 (2023): 825. http://dx.doi.org/10.3390/jcm12030825.
Full textAbstract:
Traditional fistulotomy is the most performed surgical procedure in anal fistula surgery. We conducted an international online survey to explore colorectal surgeons’ opinions and preferences on fistulotomy. Considering the healing and continence impairment rates reported in the literature, surgeons were invited to answer as a hypothetic patient susceptible to being submitted to fistulotomy for low and high anal fistula. A total of 767 surgeons completed the survey from 72 countries. The majority of respondents were consultants, having treated more than 20 anal fistulas in the last year. Most of them declared that anal fistula would be able to negatively affect quality of life and would be worried/anxious about it. Taking into account all aspects, 87.5% and 37.8% of respondents would agree to be treated with a fistulotomy in case of a low and high fistula, respectively, with an acceptance rate that varied worldwide. At multivariate analysis, factors correlated to the acceptance of anal fistulotomy were male gender (p = 0.003), practice of less than 20 fistula operations during last year (p = 0.020), and low fistula (p < 0.001). Surgeons recognized the extreme complexity of this approach. This study highlighted the necessity of an accurate patients’ selection and the adoption of alternative strategy to reduce the risk of anal continence impairment.
39
Zakharyan, A. V., I. V. Kostarev, L. A. Blagodarny, et al. "Impact of the method of internal opening closure of anal fistula on outcomes after laser fistula coagulation. Preliminary results of randomized clinical trial." Koloproktologia 21, no. 3 (2022): 33–42. http://dx.doi.org/10.33878/2073-7556-2022-21-3-33-42.
Full textAbstract:
AIM: to estimate the outcomes after fistula laser coagulation for transsphincteric anal fistulas.PATIENTS AND METHODS: a prospective randomized single-center study included 42 patients with transsphincteric anal fistulas, 36 (85.7%) of them had a follow-up > 3 months. Nineteen patients were randomized to the group of laser thermocoagulation of the fistula track (diode laser 1560 nm) combined with ligation of intersphincteric fistula track (LC + LIFT). Seventeen patients were randomized to the group of laser thermocoagulation of the fistula combined with closure of internal fistula opening by advancement flap (LC + AF). Mean follow-up period was 6.5 months. Perioperatively (before surgery, 1 and 2 months after surgery), patients underwent ultrasound to assess fistula healing and early detection of recurrence.RESULTS: no intraoperative and early postoperative complications occurred. In the LC + LIFT group, healing rate was 89,5% (17/19 patients), in the LC + AF group — 64.7% (11/17patients). Endorectal ultrasound confirmed healing or early recurrence. No significant factors affecting recurrence rate were identified in both groups.CONCLUSION: treatment of transsphincteric anal fistulas by LC + LIFT showed better results compared with LC + AF technique. However, further recruitment of patients into study groups is required with evaluation of late results.
40
Nikita, Nikita, Shahi K.S., and Geeta Bhandari. "Fish Bone in Fistula in Ano - Report of a Rare and Interesting Case." Journal of Evolution of Medical and Dental Sciences 11, no. 3 (2022): 439–41. http://dx.doi.org/10.14260/jemds/2022/86.
Full textAbstract:
Anal fistulas are a very common surgical problem that is seen in our day-to-day practice. Anal fistula is caused by idiopathic crypto-glandular infections in more than 90% of cases. The major complications include peritonitis, perforation and perianal abscesses and fistula. There are very few cases of anal fistula caused by an ingested foreign body reported in the literature. Here we report a rare case of a 35-year-old army man who had an anal fistula with impacted fish bone. The aim of this case report is to raise a suspicion of a foreign body in case of a chronic non healing perianal fistula and to avoid injury to surgeons’ fingers while exploring or performing a digital rectal examination. Perianal abscess and fistula are a cause of significant morbidity worldwide and have been documented since the time of Hippocrates (460 BC). Anorectal sepsis accounts for 0.5-1% of all surgical admissions and constitutes 20-25% of those for colorectal disorders.1 Except for unusual disease, fistula in ano originates from infection in the anal crypts of Morgagni, forming an abscess. The abscess, when it opens, result in a tract leading to the skin surface. This brief report presents a case of fistula-in-ano with unusual aetiology that is rarely reported in literature.
41
Khitaryan, A. G., A. Z. Alibekov, S. A. Kovalev, et al. "FILAC TECHNOLOGY FOR EXTRASPHINCTERIC FISTULAS." Koloproktologia 18, no. 2 (2019): 75–81. http://dx.doi.org/10.33878/2073-7556-2019-18-2-75-81.
Full textAbstract:
AIM: to assess efficacy of FiLaC technology for extrasphincteric fistulas.PATIENTS AND METHODS: the retrospective cohort study included 56 patients with extrasphincteric fistulas of Grade III and IV. All patients underwent a modified FiLaC procedure, which consisted of excision of the fistula tract, preservation of the fistula tract inside anal canal with its laser exposure by water-absorbing Biolitec laser power of 13W and energy density of 100 J/cm. Internal fistula opening was closed with a Z-shaped absorbable suture.RESULTS: after fistula tract excision up to the anal canal we failed to insert laser probe to the internal fistulous opening in 6 (10.7%) patients due to scars. Thirty-nine (78.0%) 50 patients, who underwent FiLaC procedure were under observation with median follow-up of 27 months. Twenty (51.3%) patients had fistulas of Grade III with the recurrence occurred in 7 (35.0%) patients. Among 19 (48.7%) patients with fistulas Grade IV the recurrence was detected in all cases.CONCLUSION: FiLaC procedure is effective only for extrasphincteric fistulas Grade III.
42
Arai, Nobuyasu, Takahiro Kudo, Kazuhide Tokita, et al. "Effectiveness of Biological Agents in the Treatment of Pediatric Patients with Crohn’s Disease and Anal Fistulae." Digestion 102, no. 5 (2021): 783–88. http://dx.doi.org/10.1159/000512900.
Full textAbstract:
<b><i>Introduction:</i></b> Anal fistulae have a significant impact on the quality of life of patients with Crohn’s disease (CD). In this cross-sectional study, we aimed to determine whether biological agents were effective in treating anal fistulae in patients with CD. <b><i>Methods:</i></b> Fifty-three patients diagnosed with CD were retrospectively enrolled. Their data regarding symptoms, treatments, and disease progression from January 2007 to December 2016 were reviewed from the medical records. Fifteen (28%) patients with CD were complicated by anal fistulae. <b><i>Results:</i></b> The male-to-female ratio was 13:2, and the mean age at onset was 11 years and 6 months. Among the 15 patients, 14 (93%) had anal fistulae as an initial symptom. Almost all patients were treated by providing elemental diet, 5-aminosalicylic acid, and steroids as induction therapy. Biological agents were used in 8 patients (53.3%), and fistula closure was confirmed in all of them. Among the 7 patients not treated with biological agents, 1 (14.3%) had a recurrent anal fistula, while another had incomplete fistula closure. Regarding surgical management, 2 patients were treated using the seton method, and no patients required a colostomy. <b><i>Conclusion:</i></b> Treatment with biological agents is highly effective concerning the closure of anal fistulae in patients with CD, and reducing pain may improve their quality of life.
43
Owen, HA, GN Buchanan, A. Schizas, R. Cohen, and AB Williams. "Quality of life with anal fistula." Annals of The Royal College of Surgeons of England 98, no. 5 (2016): 334–38. http://dx.doi.org/10.1308/rcsann.2016.0136.
Full textAbstract:
Introduction Anal fistula affects people of working age. Symptoms include abscess, pain, discharge of pus and blood. Treatment of this benign disease can affect faecal continence, which may, in turn, impair quality of life (QOL). We assessed the QOL of patients with cryptoglandular anal fistula. Methods Newly referred patients with anal fistula completed the St Mark’s Incontinence Score, which ranges from 0 (perfect continence) to 24 (totally incontinent), and Short form 36 (SF–36) questionnaire at two institutions with an interest in anal fistula. The data were examined to identify factors affecting QOL. Results Data were available for 146 patients (47 women), with a median age of 44 years (range 18–82 years) and a median continence score of 0 (range 0–23). Versus population norms, patients had an overall reduction in QOL. While those with recurrent disease had no difference on continence scores, QOL was worse on two of eight SF–36 domains (p<0.05). Patients with secondary extensions had reduced QOL in two domains (p<0.05), while urgency was associated with reduced QOL on five domains (p<0.05). Patients with loose seton had the same QOL as those without seton. No difference in urgency was found between patients with and without loose seton. In primary fistula patients, 19.4% of patients experienced urgency versus 36.3% of those with recurrent fistulas. Conclusions Patients with anal fistula had a reduced QOL, which was worse in those with recurrent disease, secondary extensions and urgency. Loose seton had no impact on QOL.
44
Liao, Fan-Ting, and Chi-Jen Chang. "Initial Experience with Fibrin Glue Treatment of Anal Fistulae in Children." American Surgeon 84, no. 6 (2018): 1105–9. http://dx.doi.org/10.1177/000313481808400673.
Full textAbstract:
Pediatric anal fistulae commonly result from recurrent perianal abscesses, of which nearly 50 per cent develop an anal fistula. The purpose of this study was to report the results of using fibrin glue to treat anal fistula in pediatric patients. Infants and children with recurrent perianal abscesses and anal fistulae were treated with either fistulectomy or fibrin glue. Demographic and clinical characteristics and outcomes were compared between the groups. A total of 34 children were included; 27 received fistulectomy (median age eight months) and seven received fibrin glue treatment (median age 14 months). No significant differences in demographic or clinical characteristics were found between the two groups (all, P > 0.05). Median follow-up duration was significantly higher in the fibrin glue group compared with that in the fistulectomy group (five months vs one month, P = 0.003). There was one recurrence in the fistulectomy group, and no recurrences in the fibrin glue group (P = 1.0). No complications occurred in either group. Fibrin glue treatment is a simple and effective treatment alternative in the management of anal fistula in children, offering the advantage of sphincter muscle-sparing and reduced risk of fecal incontinence.
45
Xu, Yansong, and Weizhong Tang. "Ligation of Intersphincteric Fistula Tract Is Suitable for Recurrent Anal Fistulas from Follow-Up of 16 Months." BioMed Research International 2017 (2017): 1–4. http://dx.doi.org/10.1155/2017/3152424.
Full textAbstract:
Since 2007, ligation of the intersphincteric fistula tract (LIFT) for the management of anal fistula was all introduced with initial success and excitement. It remains controversial which surgical procedure is suitable for transsphincteric fistula, especially to complex anal fistula. This retrospective study was designed to evaluate the results in patients with recurrent anal fistula by LIFT. A retrospective study of 55 complex fistula patients who underwent LIFT procedure in a single medical center was analyzed. Patients and fistula characteristics, complications, and recurrences were reviewed. All 55 patients underwent the procedure with a median follow-up of 16 months. Median operative time was 44 (range 23–88) minutes. Of the 55 patients, 33 (60%) healed completely and did not require any further surgical treatment at end of follow-up. Twenty-two (40%) recurrences and six complications were observed. Compared with patients who had undergone more than two surgical procedures, LIFT was more suitable for patients who had undergone one to two surgical procedures, and significant difference was observed in number of operations before LIFT (p=0.002). Clinicians can consider the use of LIFT for the treatment of recurrent anal fistulas. A larger number of patients and prospective study are needed to be performed.
46
Matinyan, A. V., I. V. Kostarev, L. A. Blagodarniy, A. Yu Titov, and Yu A. Shelygin. "FISTULA LASER ABLATION FOR ANAL FISTULAS (systematic review)." Koloproktologia 18, no. 3(69) (2019): 7–19. http://dx.doi.org/10.33878/2073-7556-2019-18-3-7-19.
Full textAbstract:
AIM: to reveal fistula healing incidence after application of FiLaC™ technique and factors that can affect it. MATERIALS AND METHODS: when searching electronic medical databases for publications that evaluated the results of the FiLaC™ technique in the treatment of anal fistula, 6 studies were selected, corresponding to the search queries. The search was carried out taking into account the principles of systematic literature reviews and meta-analyses (PRISMA). The time interval for searching publications was between 2011 and October 2018. In the publications included in the analysis, the following parameters were evaluated: general characteristics of the study groups, technical aspects of the FiLaC™ technique, the site of the fistula in relation to the anal sphincter, the option of closing the internal fistula, the incidence of healing and recurrence of fistula, the duration of the follow-up period after surgery, re-operated cases of fistula recurrences. RESULTS: taking into account the data obtained in the analysis of the selected studies, the mean incidence of fistula healing was 64.5% (40.0-88.2)%. It was found that the only factors that can be used to assess their impact on the incidence of fistula healing were: the gender and the variant of the fistula site in relationship to the anal sphincter (transsphincteric/extrasphincteric). Statistical analysis and evaluation of the odds ratio revealed no effect on the treatment result of the above parameters. CONCLUSION: the analysis of the data showed that FiLaCis mainly indicated for the treatment of patients with extrasphincter and transsphincteric anal fistulas. The method can be recommended as a sphincter-sparing treatment in patients with initially weakened anal sphincter function and, consequently, with a high risk of anal sphincter insufficiency in the application of traditional techniques. Further evaluation of the treatment results in the treated period and their comparison with the results after other variants of coagulation of the fistula walls is required to obtain a clearer understanding of the effectiveness of the FiLAC technique.
47
Dr. Manjunath Savanth, Dr. Clement R S Dsouza, Dr. Reshmina Chandni Clara Dsouza, and Dr.Shubha N Rao. "An Evaluation of The Various Modalities Used for Treatment of Low Fistulas and Their Outcome at a Tertiary Care Center." IAR Journal of Medicine and Surgery Research 1, no. 3 (2020): 24–27. http://dx.doi.org/10.47310/iarjmsr.2020.v01i03.06.
Full textAbstract:
fistula-in-ano is an abnormal hollow tract or cavity that is lined with granulation tissue and that connects a primary opening insidethe anal canal to a secondary opening in the perianal skin; secondary tracts may be multiple and can extend from the same primary opening. Anal fistula is a common peri-anal surgical problem with which the patient presents the clinician. Most anal fistulas form a good treatable benign lesion of the rectum and anal canal. 90% or more of these cases are a finale of the infections of the cryptoglandulares. As such, the vast majority of these infections are acute and significant majority is a contributory to chronic, low-grade infections.
48
de Parades, V., J. D. Zeitoun, and P. Atienza. "Cryptoglandular anal fistula." Journal of Visceral Surgery 147, no. 4 (2010): e203-e215. http://dx.doi.org/10.1016/j.jviscsurg.2010.07.007.
Full text
49
Bartram, Clive, and Gordon Buchanan. "Imaging anal fistula." Radiologic Clinics of North America 41, no. 2 (2003): 443–57. http://dx.doi.org/10.1016/s0033-8389(02)00122-7.
Full text
50
Garcia-Aguilar, Julio, Carlos Belmonte, Douglas W. Wong, Stanley M. Goldberg, and Robert D. Madoff. "Anal fistula surgery." Diseases of the Colon & Rectum 39, no. 7 (1996): 723–29. http://dx.doi.org/10.1007/bf02054434.
Full text