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Journal articles on the topic 'High Complex Fistula'

Author: Grafiati

Published: 2 June 2025

Last updated: 31 July 2025

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1

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.

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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 a

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2

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.

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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 bo

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Sreekumar, S., R. V. Subramanian, J. Akhter, and M. Muralidharan. "A study on validity of Goodsall's rule in accurately predicting the course of anal fistulous tract; comparison with MRI and surgical findings." Sri Lanka Journal of Surgery 43, no. 1 (2025): 12–17. https://doi.org/10.4038/sljs.v43i1.9176.

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Background: Fistula-in-ano is a granulation tissue lined tract that opens deeply in the anal canal or rectum and superficially on the perianal skin. Most of these fistulae are formed from ano rectal abscess which burst spontaneously. The secondary causes of fistula in ano include conditions such as Crohn’s disease, Tuberculosis and Carcinoma rectum. Fistula in ano can be broadly classified into Anterior and Posterior, Low lying or High Fistula in ano as well as Simple and Complex fistula in ano. Goodsall’s rule depicts the relationship of the external opening of the fistula with the course of

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Palak, Gandhi, Kumar Gaur Arun, and Modi Bhoomi. "Fistula in Ano: MRI and Post-Operative Findings Correlation." International Journal of Pharmaceutical and Clinical Research 15, no. 3 (2023): 1257–67. https://doi.org/10.5281/zenodo.12790015.

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<strong>Objective:</strong> To asses role of MRI in perianal fissure and fistula and to evaluate complications. <strong>Materials and Methods: </strong>Total 50 patients, who were clinically diagnosed as suffering from perianal fissure/fistula, were recruited. Each patient was studied in detail with relevant clinical history and Examination. MRI was performed on 1.5 T Philips scanner with patient in prone position using body coil, no special bowel preparation was used. <strong>Results: </strong>A total of 50 cases of perianal fissure/fistula, most patients were in age

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International, Journal of Medical Science and Innovative Research (IJMSIR). "Laser Therapy: A Breakthrough for Treating Complex High Intersphincteric Fistulas." International Journal of Medical Science and Innovative Research (IJMSIR) 9, no. 4 (2024): 61–67. https://doi.org/10.5281/zenodo.15424366.

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<strong>Abstract</strong> <strong>Introduction: </strong>High Intersphincteric Tracts can be present in high complex, intersphincteric   or complex transsphincteric fistulas. The tracts usually seen traversing up the intersphincteric plane while performing the Trans anal opening of intersphincteric plane, they can end blind or rectal perforation can be traced up. Treating these very thin tracts is challenging and if untreated, can cause of recurrence of fistula.  <strong>Methods: </strong>Retrospective analysis of 12 patients with high complex fistula treated with trans anal ope

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Wang, Ya-Qun, Yan Wang, Xiao-Feng Jia, Qiao-Jing Yan, and Xue-Ping Zheng. "High complex anal fistula managed by the modified transanal opening of the intersphincteric space via the inter-sphincteric approach: A case report." World Journal of Radiology 16, no. 10 (2024): 552–60. http://dx.doi.org/10.4329/wjr.v16.i10.552.

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BACKGROUND High complex anal fistulas are epithelialized tunnels, with the main fistula piercing above the deep external sphincter and the internal opening approaching the dentate line. Conventional surgical procedures for high complex anal fistulas remove most of the external sphincter and damage the anorectal ring. Postoperative loss of anal function can cause physical and mental damage. Transanal opening of the intersphincteric space (TROPIS) is an effective procedure that completely preserves the external anal sphincter. However, its clinical application is limited by challenges in the loc

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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.

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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 an

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8

Garg, Pankaj, Kaushik Bhattacharya, Vipul D. Yagnik, and G. Mahak. "Recent advances in the diagnosis and treatment of complex anal fistula." Annals of Coloproctology 40, no. 4 (2024): 321–35. http://dx.doi.org/10.3393/ac.2024.00325.0046.

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Anal fistula can be a challenging condition to manage, with complex fistulas presenting even greater difficulties. The primary concerns in treating this condition are a risk of damage to the anal sphincters, which can compromise fecal continence, and refractoriness to treatment, as evidenced by a high recurrence rate. Furthermore, the treatment of complex anal fistula involves several additional challenges. Satisfactory solutions to many of these obstacles remain elusive, and no consensus has been established regarding the available treatment options. In summary, complex anal fistula has no es

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9

Husain, Musharraf, Mir Mujtaba Ahmad, Tajamul Rashid, and Ajay Kumar Thakral. "Ligation of intersphincteric fistula tract for complex fistula in ano at a tertiary care centre in Northern India: A 3-year prospective study." Journal of Clinical Sciences 22, no. 1 (2025): 27–30. https://doi.org/10.4103/jcls.jcls_54_24.

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ABSTRACT Background: An anal fistula is an abnormal pathological tract between the anal canal and the perianal skin which primarily originates from the crypto-glandular infection. The estimated prevalence of anal fistula is 1/10,000 per year and male to female ratio is 1.8:1. Various treatment options available are: fistulotomy, application of fibrin glue, endorectal advancement flap, fistula plug, VAAFT (video-assisted technique) and ligation of the intersphincteric fistula tract (LIFT). Every procedure has its own merits and demerits which need to be evaluated. The study aimed to assess the

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Praveen, R. Krishnan, Daniel Elizabeth, Prem L. Chinchu, and Verghese T. Josey. "The Predictive Accuracy of Magnetic Resonance Imaging (MRI) Findings in Identifying Anorectal Fistula over Intraoperative Findings." International Journal of Toxicological and Pharmacological Research 14, no. 3 (2024): 127–33. https://doi.org/10.5281/zenodo.10961054.

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<strong>Introduction:</strong> Fistula-in-ano, also referred to as the anal fistula, is an abnormal tract or cavity between the anal canal and perianal skin. The treatment of fistulas requires surgery. Proper manipulations, such as curettage and drainage of blind sinuses, abscess cavities, and accessory tracts, are the key for successful treatment. Owing to high soft tissue resolution of MRI, radiologists can provide detailed anatomic descriptions of the relationship between the fistula and the anal sphincter complex, localization of the site of internal opening of anal fistula, definitio

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Verma, Amrendra, Reena Kothari, Dhananjaya Sharma, and Pawan Agarwal. "Cutting of Sphincter in Fistulectomy with Primary Closure in Complex Fistula-in-Ano: Is it Feasible?" Journal of Coloproctology 43, no. 03 (2023): e204-e207. http://dx.doi.org/10.1055/s-0043-1774726.

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Abstract Introduction Treatment of complex fistulas such as inter- or transsphincteric, recurrent, and high fistulae have high rate of recurrence or incontinence. Fistulectomy with primary sphincter reconstruction might represent an effective and safe alternative to reduce rate of recurrence and incontinence. The aim of this study is to assess incontinence and recurrence after fistulectomy with primary sphincter reconstruction for management of complex fistulas. Material and Methods There were 60 patients with complex fistulae involving the sphincter, with 56 male and 4 female, mean age 40.6 y

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12

Gupta, Rashmi. "MODIFIED KSHARSUTRA TECHNIQUE IN COMPLEX FISTULA IN ANO - A CASE STUDY." International Ayurvedic Medical Journal 8, no. 10 (2020): 4939–43. http://dx.doi.org/10.46607/iamj6308102020.

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Fistula in ano is an anorectal disorder in which two openings are present. One is located near perianal re-gion and another is at anal canol or rectum. Fistula in ano is itself a challenging disease for patients because of mortality is not associated but daily routine life of patients become crushed. Ayurveda also said about Bhagandar (fistula in ano) that it is Kashta Shadhya Vyadhi i.e. difficult to treat because its take time and recurrence rate is also associated. But Ayurveda has described the Kshar sutra therapy for the treatment of fistula in ano which have high success rate, but time t

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Thiagarajan, Senthil Kumar. "Vesico-Salpingo Fistula Masquerading as Hydrosalpinx with Neurogenic Bladder - An Interesting Case Report." Journal of Evolution of Medical and Dental Sciences 10, no. 34 (2021): 2942–44. http://dx.doi.org/10.14260/jemds/2021/600.

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A fistula is an abnormal connection between two luminal structures of different epithelium. The majority of urological fistulas in developed countries are consequences of iatrogenic injury most commonly laparoscopic hysterectomies, or from radiotherapy in the treatment of pelvic cancers.1 Contrary to this, most obstetric fistulas in developing countries result from obstructed labour during childbirth.2 Common factors that contribute to obstructed labour in developing countries are delayed presentation after trial labour at home, cephalopelvic disproportion and poor nutrition. Due to prolonged

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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.

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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. Th

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Culafic, Slobodan, Robert Juszkat, Sinisa Rusovic, Dara Stefanovic, Ljubodrag Minic, and Milan Spaic. "Endovascular treatment of carotid-cavernous fistula type A with platinium coils." Vojnosanitetski pregled 65, no. 12 (2008): 923–26. http://dx.doi.org/10.2298/vsp0812923c.

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Background. Carotid-cavernous fistulas are abnormal communications between carotid arteries or their branches and the cavernous system caused mostly by trauma. Posttraumatic fistulas represent 70% of all carotid-cavernous fistulas and they are mostly high-flow shunts (type A). This type gives characteristic eye symptoms. Case report. This paper presents a 44-year old male patient with carotidcavernous fistula as a result of penetrating head injury. In clinical presentation the patient had exophthalmos, conjunctival chemosis and weakening of vision on the right eye, headache and diplopia. Digit

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16

Rydzek, Martyna, Przemysław Ciesielski, and Piotr Diuwe. "The results of high-position anal fistula treatment using the LIFT (ligation of intersphincteric fistula tract) procedure. A retrospective, single-center study." Polish Journal of Surgery 93, no. 4 (2021): 1–5. http://dx.doi.org/10.5604/01.3001.0014.8769.

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Introduction Ligation of intersphincteric fistula tract (LIFT) is an established method for the treatment of high- and low-position anal fistulas. Numerous meta-analyzes confirm the high healing success rate with simultaneous low risk of sphincter damage. Purpose of the work The aim of the study was to evaluate the results of the treatment of patients with high-position and complex transsphincteric fistulas using the LIFT procedure. Material and method: Twelve patients (M-9, F-3) aged between 28 and 69 (median age 50) undergoing surgery for complex and high-position transsphincteric anal fistu

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17

SCARDILLO, J. "Management of a complex high-output fistula." Journal of WOCN 25, no. 4 (1998): 217–20. http://dx.doi.org/10.1016/s1071-5754(98)90066-3.

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18

Scardillo, Jody, and Beverly Folkedahl. "Management of A Complex High-Output Fistula." Journal of Wound, Ostomy and Continence Nursing 25, no. 4 (1998): 217–20. http://dx.doi.org/10.1097/00152192-199807000-00013.

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19

Karna, Rahul, Balaji Jagdish, Nabeeha Mohy-Ud-Din, and Abhijit Kulkarni. "Iliac Artery–Inferior Vena Cava–Duodenal Fistula: An Unusual Cause of Massive Gastrointestinal Bleeding." ACG Case Reports Journal 10, no. 9 (2023): e01132. http://dx.doi.org/10.14309/crj.0000000000001132.

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ABSTRACT An arteriovenous-enteric fistula is a 3-way connection between the vascular and enteric system and associated with high mortality. We describe a case of iliac artery–inferior vena cava–duodenal fistula in a young female with a retroperitoneal mass presenting with sepsis and hemorrhagic shock with a catastrophic clinical course. These fistulas can be missed on endoscopy/colonoscopy and are usually diagnosed on computed tomography angiogram of the abdomen. Complex vasculoenteric fistula should be among differentials in patients presenting with gastrointestinal bleeding, especially with

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Kostarev, Ivan, Anushavan Matinyan, Alexander Titov, et al. "Treatment of complex trans- and extrasphincteric fistulas by laser thermo-obliteration of fistula tract: preliminary results." Hirurg (Surgeon), no. 3-4 (April 1, 2020): 34–42. http://dx.doi.org/10.33920/med-15-2002-04.

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The aim of this study was to assess the preliminary results of treatment of patients with complex transand extrasphincteric fistulas by laser thermo-obliteration of fistula tract. Materials and methods. The analysis was conducted on 28 patients with complex trans- and extrasphincteric fistulas (24 males and 4 females). The age of patients ranged from 29 to 68 years (on the average 43±12.4). In 8 (28.6 %) patients there were extrasphincteric fistulas, in 20 (71.4 %) — transsphincteric fistulas. The minimum assess period at which healing or preservation of the fistula was diagnosed was 2 months

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Moroni, Bruno M., Juan P. Muñoz, Camila C. Battú, Pedro E. Straini, Gustavo C. Theiler, and Rosana Valentini. "Fístula perianal compleja. Tratamiento con plasma rico en plaquetas." Revista Argentina de Cirugía 112, no. 2 (2020): 197–202. http://dx.doi.org/10.25132/raac.v112.n2.1430.es.

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A male patient with a diagnosis of steroid dependent inflammatory bowel disease (ulcerative colitis) sought medical care due to complex perianal fistula with extended chronic inflammation of the perianal region that was successfully treated with platelet-rich plasma as a single therapy. The benefits of autologous platelet-rich plasma for the treatment of this type of fistulas are presented. In this way, there is no need to perform surgery in a chronic inflammatory territory with high rate of complications and recurrence affecting patients’ quality of life.

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Islam, Md Armanul, Md Mahfuzur Rahman Khan, Md Mustafizur Rahman, et al. "Outcome of Seton in the Management of Complex Fistula in Ano in a Tertiary Care Center in Bangladesh." Journal of Shaheed Suhrawardy Medical College 12, no. 1 (2021): 15–19. http://dx.doi.org/10.3329/jssmc.v12i1.51613.

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Background: The management of high and complex anal fistulas remain a therapeutic challenge as it is often associated with recurrence and anal incontinence. The oldest and theoretically the simplest technique is to use a seton. The aim of this study is to find out the outcome of seton in the treatment of complex fistula in ano. Materials and methods: This cross-sectional study was done in surgical units of ShSMCH and colorectal surgery units of BSMMU from September 2014 to August 2015. Fifty patients with high anal fistula having internal opening above dentate line and with multiple fist

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Udo IA and Umoh MS. "Enterocutaneous fistula: A review of literature." Ibom Medical Journal 3, no. 1 (2008): 13–17. http://dx.doi.org/10.61386/imj.v3i1.20.

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Enterocutaneous fistula carries a high morbidity and mortality; it is preventable with good surgical decision making. It is common with emergency abdominal procedures but could arise from trauma or spontaneously. Complicated hernias still cause this condition in tropical Africa.The management requires early recognition and control of ongoing metabolic and nutritional abnormalities. Enteral nutrition is adequate in distal fistulas. Surgery is not considered a priority in management; it is reserved for complex fistulas.

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Dashti, Shervin R., Robert F. Spetzler, Min S. Park, Michael F. Stiefel, Humain Baharvahdat, and Cameron G. McDougall. "Multimodality Treatment of a Complex Cervicocerebral Arteriovenous Shunt in a Patient With CHARGE Syndrome." Neurosurgery 67, no. 1 (2010): E208—E209. http://dx.doi.org/10.1227/01.neu.0000371064.91216.ab.

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Abstract OBJECTIVE We present our management of a unique case of complex arteriovenous shunt with vascular steal in the left-sided head and neck vessels in a child with CHARGE (Coloboma of the eye, Heart defects, Atresia of the choanae, Retardation of growth and/or development, Genital and/or urinary abnormalities, and Ear abnormalities and deafness) syndrome. CLINICAL PRESENTATION A 10-year-old girl presented with high-output heart failure. Cerebral angiography revealed high-flow abnormal fistulous connections between the left common carotid artery and innominate vein as well as between the v

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Sukentro, Tony, Ya Thohir, Reza Yuridian Purwoko, Asmail, and Berliano Karvenio. "FiLaCTM: The Latest Revolution in Anal Fistula Treatment - A Literature Review of Various Therapeutic Techniques." International Journal of Science and Society 6, no. 2 (2024): 386–93. http://dx.doi.org/10.54783/ijsoc.v6i2.1154.

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Anal fistula, an abnormal tunnel anal and rectal’s mucosa to surrounding skin in anus or perianal region, has long been considered a complex clinical challenge. This condition often poses a threat in long-term treatment due to the recurrence high risk and incontinence. In this article, we narratively review a number of scientific literatures regarding new treatment techniques which been employed to address anal fistula in the past five years. We objectively evaluate the pros and cons of each technique according to clinical outcomes, and aim to explore the most effective treatment strategy for

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Shrestha, Monica, and Tukaram S. Dudamal. "Management of of complex fistula-in-ano by a IFTAK technique - case report." Healer 2, no. 1 (2021): 119–22. http://dx.doi.org/10.51649/healer.47.

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Ksharsutra is a Medicated seton which is made by coating the Barbour thread with 21 coatings of Kshara i.e. an herbal alkaline powder, turmeric and latex of Euphorbia nerrifolia. Ksharsutra application is a minimal invasive well established procedure in management of fistula-in-ano. Research on Ksharsutra started since 1968 and it is being used till date with high success rate. In this case report the patient was asymptomatic before 15 years but then a boil developed at perianal region which spontaneously bursted and pus discharge was seen from the boil. Patient was diagnosed with Grade 5 St.

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Biswas, Swapan Kumar, ASM Tanjilur Rahman, Muhammad Mofazzal Hossain, and Saiful Islam Khan. "Ligation of the Intersphincteric Fistula Tract (LIFT) Technique in the Treatment of Complex Perianal Fistula: Experience of First 50 Cases." Faridpur Medical College Journal 15, no. 1 (2020): 3–7. http://dx.doi.org/10.3329/fmcj.v15i1.48999.

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Perianal fistula is a common disease and surgery is the only treatment option. Many surgical techniques have been described. Ligation of intersphincteric fistula tract (LIFT) is a sphincter saving surgical technique in which fistula tract is ligated and excised through intersphincteric approach. The aim of study is to present our experience of first 50 LIFT procedures particularly healing rate, recurrence rate and complications from the procedure. This is a prospective observational study started from March 2018 on whom underwent LIFT procedure for primary complex perianal fistula of infective

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Buchberg, Brian, Hossein Masoomi, John Choi, Herlinda Bergman, Steven Mills, and Michael J. Stamos. "A Tale of Two (Anal Fistula) Plugs: Is there a Difference in Short-Term Outcomes?" American Surgeon 76, no. 10 (2010): 1150–53. http://dx.doi.org/10.1177/000313481007601030.

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Treatment of complex anal fistulas presents an ongoing challenge to colorectal surgeons. The anal fistula plug is an attractive definitive option due to its minimal risk of incontinence, simple design, and easy application. Our objective was to compare the Cook Surgisis® AFP™ plug and the newer Gore Bio-A® plug in the management of complex anal fistulas. A retrospective chart review of patients treated with Cook and Gore fistula plugs between August 2007 and December 2009 was performed. Success was defined as closure of all external openings and absence of drainage and abscess formation. Twelv

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Atroschenko, A. O., S. V. Pozdnyakov, and A. V. Teterin. "Minimally invasive video-assisted sphincter-sparing treatment of complex rectal fistulas using the VAAFT technique." Pelvic Surgery and Oncology 10, no. 3-4 (2020): 27–33. http://dx.doi.org/10.17650/2686-9594-2020-10-3-4-27-33.

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Background. Video-assisted anal fistula treatment (VAAFT) is a new minimally invasive sphincter-sparing technology.Objective: to describe technical characteristics of VAAFT and evaluate short-term outcomes.Materials and methods. We used a specialized surgical video system (VAAFT®; Karl Storz) for the treatment of complex high rectal fistulas. This technology allows a surgeon to use a special fistuloscope to perform visual examination of the fistula, find its internal opening, and detect secondary fistula passages and inflows. In addition to visual inspection, it is possible to simultaneously c

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Jovani, Manol, Linda Zhang, Yuting Huang, and Vivek Kumbhari. "Multi-layer endoscopic suturing: a novel method of gastric fistula closure." Endoscopy International Open 09, no. 10 (2021): E1520—E1523. http://dx.doi.org/10.1055/a-1517-4405.

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Abstract Background and study aims Current endoscopic methods of treating gastric fistulas are either too complex or have high rates of recurrence. We aimed to provide a novel endoscopic method for robust fistula closure. Patients and methods This was a single-center, retrospective study of five patients who underwent multi-layer endoscopic suturing for closing of a chronic fistula (> 4 weeks). Devitalization of the fistula tract was achieved with argon plasma coagulation, followed by endoscopic suturing of the fistula. Then, endoscopic suturing of the gastric wall surrounding the fistula w

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Khan, Junaid H., Sarah B. Rahman, Doff B. McElhinney, et al. "Management Strategies for Complex Bronchopleural Fistula." Asian Cardiovascular and Thoracic Annals 8, no. 1 (2000): 78–84. http://dx.doi.org/10.1177/021849230000800124.

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The management of complex bronchopleural fistula remains a major therapeutic challenge for the thoracic surgeon. Although the incidence of bronchopleural fistula following lung resection has decreased in recent years to 1% to 2%, when it occurs, it is associated with significant morbidity and mortality. Using illustrative cases, the epidemiology and pathophysiology of bronchopleural fistula are reviewed and operative strategies are discussed. Algorithms for the diagnosis and treatment are suggested on the basis of cases described in the literature. The best way to prevent a fistula is to rigor

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Merten, Jennifer, Ann-Kathrin Eichelmann, Rudolf Mennigen, Isabelle Flammang, Andreas Pascher, and Emile Rijcken. "Minor Sphincter Sparing Surgery for Successful Closure of Perianal Fistulas in Patients with Crohn’s Disease." Journal of Clinical Medicine 10, no. 20 (2021): 4721. http://dx.doi.org/10.3390/jcm10204721.

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The purpose of this study is to demonstrate that repetitive minor surgical procedures allow for a high rate of permanent closure of perianal fistulas in patients with Crohn’s disease (CD). Patients with perianal fistulizing CD (PFCD) who underwent perianal surgery at the University Hospital of Muenster between 2003 and 2018 were assessed for fistula characteristics and surgical procedures. We included 45 patients (m:f = 28:17) with a mean age of 27 years at first fistula appearance. Of these, 49% suffered from a complex fistula. An average of 4.2 (1–14) procedures were performed, abscess incis

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Tran, Henry, Ryan Flannigan, and Daniel Rapoport. "Transperineal approach to complex rectourinary fistulae." Canadian Urological Association Journal 9, no. 11-12 (2015): 916. http://dx.doi.org/10.5489/cuaj.3107.

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<p><strong>Introduction:</strong> We sought to present our experience and outcomes in patients with complex rectourethral fistulae (RUF) treated using the transperineal approach with gracilis muscle flap interposition. Complex RUF was defined as having prior radiation, failed repair attempts, and large size (&gt;2 cm).</p><p><strong>Methods:</strong> A retrospective review identified 10 patients presenting with complex RUF between July 2009 and November 2013. Three were excluded due to large fistula defects managed with urinary diversion. Seven pat

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Moon, Karam, Andrew F. Ducruet, R. Webster Crowley, Kathleen Klas, Ruth Bristol, and Felipe C. Albuquerque. "Complex dural arteriovenous fistula in Bannayan-Riley-Ruvalcaba syndrome." Journal of Neurosurgery: Pediatrics 12, no. 1 (2013): 87–92. http://dx.doi.org/10.3171/2013.3.peds12551.

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In this paper the authors report the case of a complex dural arteriovenous fistula (dAVF) with high-risk features in a 14-year-old girl with Bannayan-Riley-Ruvalcaba syndrome (BRRS), a phosphatase and tensin homolog–associated syndrome, presenting with signs and symptoms of increased intracranial pressure (ICP) that had previously been attributed to pseudotumor cerebri. This fistula was obliterated following 2 stages of embolization, and the patient experienced immediate symptomatic improvement. At the 2-month follow-up evaluation, the fistula remained angiographically occluded, and her sympto

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Chinta, Anjini Suvarchala Devi, Samson Subhash Palaparthy, U. Deepthi N, Sirisha Bevunapalli, and Bevunapalli Rakesh. "A Study on Different Treatment Modalities in the Management of Anal Fistula." International Journal of Pharmaceutical and Clinical Research 16, no. 10 (2024): 1254–56. https://doi.org/10.5281/zenodo.14176662.

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<strong>Introduction:</strong> Anal fistula, a common anorectal condition, is treated using various modalities like fistulotomy, fistulectomy, fibrin glue, fistula plug insertion, ligation of the intersphincteric tract (LIFT), and video-assisted anal fistula treatment (VAAFT). Each has distinct advantages and challenges. This study aimed to assess the efficacy, complications, and adherence to treatment principles of these five techniques. <strong>Methods: </strong>This cross-sectional study at Konaseema Institute involved adult patients with primary or recurrent anal fistulas. T

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Sarda, Hitesh, Anshuman Pandey, Sudip Regmi, and Shakeel Masood. "Magnetic resonance imaging for fistulography in perianal fistula: clinicoradiological correlation." International Surgery Journal 9, no. 9 (2022): 1553. http://dx.doi.org/10.18203/2349-2902.isj20222094.

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Background: This article aims to review the role of magnetic resonance imaging (MRI) fistulography in evaluation of perianal fistula along with its concordance with clinical examination and impact on surgical intervention.Methods: A retrospective study of 61 patients who underwent surgery for anal fistula in RMLIMS collected from database from January 1, 2017 to September, 2021Results: The study showed a significant MRI contribution to clinical evaluation in 65.6%. MRI provided significant information for complex fistulas than for simple fistulas (45% vs. 14.6%, p=0.01). Proportion of patient

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Choudhri, Omar, and Gary K. Steinberg. "Microsurgical treatment of a tentorial galenic dural arteriovenous fistula." Neurosurgical Focus 40, videosuppl1 (2016): 1. http://dx.doi.org/10.3171/2016.1.focusvid.15420.

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Tentorial dural arteriovenous fistulae (TDAVFs) are complex lesions with the arteriovenous fistula located between the leaves of the tentorium cerebelli. While a large portion of dural arteriovenous fistulae are treated endovascularly, TDAVF may require additional microsurgical treatment given their high risk of hemorrhage and multitude of feeders. We describe the case of a 65-year-old male who presented with hemorrhage from a straight sinus and galenic TDAVF. The straight sinus portion of the fistula was obliterated by 3 endovascular treatments and 1 microsurgical treatment. The galenic compo

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Wushouer, Abuduwaili, Ma Mu Ti Jiang A Ba Bai Ke Re, and Irshat Ibrahim. "Outcome of hybrid seton placement for the treatment of high complex anal fistulas with and without tube drainage: A prospective comparative study." European Journal of Inflammation 15, no. 2 (2017): 124–30. http://dx.doi.org/10.1177/1721727x17715581.

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The aim of this study was to investigate the efficacy of treatment for complex anal fistula with cutting hybrid seton combined with tube drainage. A total of 66 consecutive patients with complex anorectal fistulae were divided into two groups: experimental group (group A with 36 patients) underwent cutting hybrid seton placement plus tube drainage and control group (group B with 30 patients) underwent same procedure without tube drainage. Comparison of clinical outcomes between two groups was conducted. The success rate, time for healing of the wound, postoperative pain, and recurrence rate we

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Fung, AKY, GV Card, NP Ross, SR Yule, and EH Aly. "Operative strategy for fistula-in-ano without division of the anal sphincter." Annals of The Royal College of Surgeons of England 95, no. 7 (2013): 461–67. http://dx.doi.org/10.1308/003588413x13629960048956.

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Introduction The treatment of perianal fistulas is diverse because no single technique is universally effective. Fistulotomy remains the most effective way of eradicating the pathology but it renders the patient at some risk of faecal incontinence, which many patients are reluctant to take. There are no data in the literature to indicate the healing rate of perianal fistulas when using an operative strategy that routinely avoids division of any part of the anal sphincter. The aim of this paper is to present the long-term results with an operative strategy that aims to avoid division of any par

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Khalaf, Ahmed A. "Augmented Pressure Distal Colostogram." Journal of the Faculty of Medicine Baghdad 56, no. 3 (2014): 268–72. http://dx.doi.org/10.32007/jfacmedbagdad.563494.

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Background: Anorectal malformations (ARMs) represent a complex group of congenital anomalies resulting from abnormal development of the hindgut, allantois and Mullerian duct, leading to incomplete or partial urorectal septal malformations . Patients and methods: This is a prospective study including sixty-five male patients with high ARMs who were admitted to the department of pediatric surgery in Children Welfare Teaching Hospital in Medical City Complex - Baghdad - Iraq ; during the period from April 2009 to November 2011 ; they were subjected to divided descending colostomy in the pos

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贾, 奎星. "Progress in the Treatment of High Complex Anal Fistula." Traditional Chinese Medicine 13, no. 01 (2024): 99–104. http://dx.doi.org/10.12677/tcm.2024.131017.

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Yoshino, H., H. Ishihara, F. Oka, S. Kato, and M. Suzuki. "Development of Indirect Cavernous Dural Arteriovenous Fistula after Trapping for Direct Carotid Cavernous Fistula." Interventional Neuroradiology 17, no. 1 (2011): 104–7. http://dx.doi.org/10.1177/159101991101700116.

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A 60-year-old man with direct carotid cavernous fistula (CCF) due to a motor vehicle accident underwent internal carotid artery trapping following high-flow external carotid to internal carotid artery bypass (EC-IC bypass). Follow-up angiography revealed ipsilateral complex indirect cavernous arteriovenous fistula. Although the traumatic indirect CCF angioarchitecture differs from cavernous-sinus dural arteriovenous fistula (CS-DAVF), the present indirect fistula was similar to the latter. Complex indirect CCF can occur after treatment of direct CCF caused by severe head injury.

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Piejko, Marcin, Michał Romaniszyn, Julia Borowczyk-Michałowska, Justyna Drukała, and Piotr Wałęga. "Cell therapy in surgical treatment of fistulas. Preliminary results." Polish Journal of Surgery 89, no. 3 (2017): 48–51. http://dx.doi.org/10.5604/01.3001.0010.1019.

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Risk of recurrence after surgical treatment of a recurrent fistula is up to 50%. It has be known that more aggressive surgical treatment is associated with a high risk of anal sphincter damage and leads to incontinence. Several studies have been designed to elaborate minimally invasive treatment of rectovaginal and anal fistulas. The properties of Adipose-derived Stem Cells (ASC) significantly enhance a natural healing potency. Here, we present our experience with combined surgical and cell therapy in the treatment of fistulas. Materials and Methods: Four patients were enrolled in our study af

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Pronk, A., K. J. Beek, M. E. Wildenberg, W. A. Bemelman, J. Stoker, and C. J. Buskens. "DOP77 Mesenchymal stem cell therapy for refractory Crohn’s perianal fistulas: a case series." Journal of Crohn's and Colitis 18, Supplement_1 (2024): i216. http://dx.doi.org/10.1093/ecco-jcc/jjad212.0117.

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Abstract Background Nearly one-third of patients with Crohn’s disease will develop one or multiple perianal fistulas within the first two decades after diagnosis, with the majority being complex. Treatment options are limited with high recurrence rates after both medical and surgical approaches. It has been demonstrated that a completely fibrotic tract on Magnetic Resonance Imaging (MRI) with a MAGNIFI-CD &lt;6 is the best predictor for long-term clinical closure. Mesenchymal stem cell treatment (MST) has emerged as a new therapeutic strategy for these fistulas. The aim of the current stud

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Pescatori, M., M. Mungo, and E. Guarino. "Combined seton-double flap procedure for complex high anal fistula." Techniques in Coloproctology 6, no. 1 (2002): 71. http://dx.doi.org/10.1007/s101510200015.

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Mills, Mandalyn, Luke Counterman, and Shanna Williams. "Diet Modification as an Adjunct to Treatment for Lymphatic Fistula Following Inguinal Lymphadenectomy: A Case Report." Wounds: a compendium of clinical research and practice 34, no. 9 (2022): e71-e73. http://dx.doi.org/10.25270/wnds/21057.

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Introduction. Lymphatic leaks following lymphadenectomy, particularly inguinal, remain an ongoing issue in postoperative wound care. Techniques such as ligation of lymphatics, omental flaps, and use of energy devices, as well as extent of surgical dissection, may be used intraoperatively to help minimize lymphedema and lymphatic leaks postoperatively. However, inguinal lymphadenectomy remains a highly morbid procedure and can lead to lymphatic fistula when a lymphatic leak is ongoing. Lymphatic fistulas are a topic of ongoing research to improve outcomes. The current standard for treatment of

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Meegada, Someswara Rao, Kishore V. Alapati, and Mathai Varughese. "Evaluation of unenhanced three-dimensional endoanal ultrasound scan in preoperative assessment of perianal sepsis." International Surgery Journal 11, no. 3 (2024): 371–77. http://dx.doi.org/10.18203/2349-2902.isj20240569.

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Background: Perianal sepsis which includes perianal fistula and abscess is a common clinical condition that requires thorough preoperative evaluation to decrease the recurrence rate and to plan relevant surgery according to the anatomy of the fistula. MRI and 3D EAUS are two important preoperative investigations that delineate the anatomy of simple and complex fistula tracts. Due to lower cost and easier use 3D EAUS is a safe and reliable first-line investigation in evaluating perianal abscess. Methods: This is a retrospective and prospective analysis of patients with perianal sepsis who under

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LeFever, Devon, Thomas Hanks, Rakesh Kumar, Philip Louie, and Jean-Christophe Leveque. "Correction of cervical kyphoscoliosis, bisected spinal cord, and vertebral artery to epidural vein fistula in neurofibromatosis type 1." Journal of Craniovertebral Junction and Spine 15, no. 1 (2024): 123–26. http://dx.doi.org/10.4103/jcvjs.jcvjs_138_23.

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ABSTRACT Neurofibromatosis-1 (NF1) presents complex challenges due to its multisystemic effects, including kyphoscoliosis, dural ectasia, and arteriovenous fistulas (AVF). We present a case of a 31-year-old male with NF1 exhibiting severe cervical kyphoscoliosis, dural ectasia, a bisected cervical cord, and an arteriovenous fistula, highlighting the intricacies of managing such intricate cases. Rapid weakening in the patient’s right arm and leg prompted imaging revealing severe cervical kyphotic deformity and a dural fold dividing the spinal cord. Surgical intervention addressed a high-flow ar

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Ahmed, Jalal, M. Meher Ullah, Asif Aman, et al. "Clinical outcome of fistulectomy with partial sphincter preservation in complex fistula-in-ano in a tertiary hospital of Bangladesh." International Surgery Journal 12, no. 7 (2025): 1131–35. https://doi.org/10.18203/2349-2902.isj20251902.

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Background: Complex fistula-in-ano poses a significant surgical challenge due to its high recurrence risk and potential for sphincter damage leading to incontinence. Sphincter-preserving fistulectomy aims to balance effective tract removal with continence preservation. This study evaluated clinical outcomes of fistulectomy with partial sphincter preservation in patients with complex fistula-in-ano. Methods: This prospective observational study was conducted in the Department of Surgery at Dhaka Medical College Hospital, Dhaka, Bangladesh, from January 2023 to June 2024. A total of 77 patients

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Rosul, Myroslav V., Bohdan M. Patskan, and Yurij P. Skrypinets. "OPTIMIZATION OF PARARECTAL FISTULA SURGICAL TREATMENT." Wiadomości Lekarskie 75, no. 10 (2022): 2412–15. http://dx.doi.org/10.36740/wlek202210117.

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The aim: To improve the results of treatment of complex PF by the ligation of the intersphincteric fistula tract (LIFT). Materials and methods: 27 patients with transsphincteric fistulas of the rectum of different complexity have been operated by two methods: by ligature method (“cutting seton”) and by the ligation of the intersphincteric fistula tract (LIFT). Results: No early complications were noticed in patients who had been applied the technique of fistula ligation in the postoperative period. The pain syndrome was expressed insignificantly. The rehabilitation period was less than 12 days

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