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Journal articles on the topic 'Intersphincteric Space'

Author: Grafiati

Published: 2 June 2025

Last updated: 31 July 2025

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1

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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Zang, Yiwen, Minwei Zhou, Deyan Tan, et al. "An anatomical study on intersphincteric space related to intersphincteric resection for ultra-low rectal cancer." Updates in Surgery 74, no. 2 (2022): 439–49. http://dx.doi.org/10.1007/s13304-022-01238-0.

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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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4

Tan, Ker-Kan, Dean C. Koh, and Charles B. Tsang. "Managing Deep Postanal Space Sepsis via an Intersphincteric Approach: Our Early Experience." Annals of Coloproctology 29, no. 2 (2013): 55. http://dx.doi.org/10.3393/ac.2013.29.2.55.

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Ryg, Una, Wolfgang Lilleby, Knut H. Hole, Marius Lund-Iversen, and Marta D. Switlyk. "Local Recurrence of Prostate Cancer to the Intersphincteric Space: A Case Report." Urology 140 (June 2020): 18–21. http://dx.doi.org/10.1016/j.urology.2020.03.009.

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Garg, Pankaj. "Comparison between recent sphincter-sparing procedures for complex anal fistulas-ligation of intersphincteric tract vs transanal opening of intersphincteric space." World Journal of Gastrointestinal Surgery 14, no. 5 (2022): 374–82. http://dx.doi.org/10.4240/wjgs.v14.i5.374.

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7

Zang, Yiwen, Bin Zhang, Xing Liu, et al. "The Effects of Intersphincteric Space Dissection Approaches on Low Rectal Cancer Outcomes: A Multicenter Retrospective Study in China." Annals of Surgery Open 6, no. 1 (2025): e550. https://doi.org/10.1097/as9.0000000000000550.

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Objective: To evaluate the effects of 2 intersphincteric space (ISS) dissection approaches for intersphincteric resection (ISR) on perioperative safety, oncological prognosis, and anal function. Background: The dissection of ISS is a crucial aspect of ISR, yet the outcomes associated with various ISS dissection approaches remain uncertain. Methods: Data were retrospectively collected from 314 patients with rectal cancer who underwent ISR at 5 Chinese tertiary referral medical institutions from January 2015 to December 2020. ISS dissection was performed using 1 of the 2 avenues: the complete tr

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Maskin, Sergey S., Alexander S. Shiryaev, Yuri V. Perov, and Vitaly V. Khomochkin. "Modified ligation method fistular tract in the interspinctern space for transfincteral pararectal fistulas." Journal of Volgograd State Medical University 20, no. 3 (2023): 105–9. http://dx.doi.org/10.19163/1994-9480-2023-20-3-105-109.

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Background: The operation of ligation of the fistulous tract in the intersphincter space (LIFT) is widely used in the world for transsphincter pararectal fistulas (TSPF). However, the frequency of fistula recurrence still cannot satisfy coloproctologists and dictates the need to modify the LIFT operation method in order to increase its reliability and safety. The aim: To present the modified LIFT technique and the results of its clinical application in the treatment of TSPF. Materials and methods: The LIFT operation modified by us (RF Patent No. 2686949) was performed in 40 patient

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Araki, Yoshiro, and Ryuzaburo Kagawa. "Ischiorectal Anal Fistulae Proceeding in the Intersphincteric Space before Penetrating the External Sphincter." Nippon Daicho Komonbyo Gakkai Zasshi 68, no. 5 (2015): 293–98. http://dx.doi.org/10.3862/jcoloproctology.68.293.

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Sahnan, Kapil, Samuel O. Adegbola, Philip J. Tozer, et al. "Innovation in the imaging of perianal fistula: a step towards personalised medicine." Therapeutic Advances in Gastroenterology 11 (January 1, 2018): 175628481877506. http://dx.doi.org/10.1177/1756284818775060.

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Background: Perianal fistula is a topic both hard to understand and to teach. The key to understanding the treatment options and the likely success is deciphering the exact morphology of the tract(s) and the amount of sphincter involved. Our aim was to explore alternative platforms better to understand complex perianal fistulas through three-dimensional (3D) imaging and reconstruction. Methods: Digital imaging and communications in medicine images of spectral attenuated inversion recovery magnetic resonance imaging (MRI) sequences were imported onto validated open-source segmentation software.

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Garg, Pankaj. "Transanal opening of intersphincteric space (TROPIS) - A new procedure to treat high complex anal fistula." International Journal of Surgery 40 (April 2017): 130–34. http://dx.doi.org/10.1016/j.ijsu.2017.02.095.

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12

Youssef, Ashraf Talaat. "Significance and Impact of the Intersphincteric Plane Sepsis in the Management of the Perianal Sepsis: Ultrasound Study." Journal of Gastrointestinal and Abdominal Radiology 04, no. 02 (2021): 149–53. http://dx.doi.org/10.1055/s-0040-1722356.

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Abstract Background The intersphincteric plane (ISP) is a potential space between the external and the internal anal sphincters. About 90% of the perianal sepsis is caused by an obstruction of the ducts of anal glands with subsequent secondary bacterial infection. The imaging modalities used to diagnose perianal sepsis are the ultrasound via endoanal and transperineal routes and magnetic resonance imaging. Objective The study aimed to identify the various patterns of the ISP sepsis and their incidence among our study group and to clarify the significance of ISP in the pathogenesis of anorectal

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Ovi, Dr Mir Rasekh Alam, Dr Shamima Nasrin, Dr Md Musab Khalil, and Dr Farhan Imtiaz Chowdhury. "Comparative Study between Open Fistulectomy and Ligation of Intersphincteric Fistulas Tract (LIFT) Procedure for Uncomplicated Perianal Fistula." Volume 5 - 2020, Issue 8 - August 5, no. 8 (2020): 753–59. http://dx.doi.org/10.38124/ijisrt20aug348.

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A new sphincter-saving procedure involving the ligation of the intersphincteric fistula tract (LIFT) procedure was recently described by Rojanasakul et al from Thailand. The main concept in the LIFT is to identify the fistula tract in the intersphincteric space and the subsequent ligation and division of the tract. Some studies abroad have shown a considerably high success rate in terms of wound healing and absence of incontinence in treating fistula-in-ano by this procedure. This study aimed to compare between the earlier fistulectomy and this new innovative LIFT technique. The study was desi

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Athanasiadis, S., A. K�hler, and M. Nafe. "Treatment of high anal fistulae by primary occlusion of the internal ostium, drainage of the intersphincteric space, and mucosal advancement flap." International Journal of Colorectal Disease 9, no. 3 (1994): 153–57. http://dx.doi.org/10.1007/bf00290193.

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Maskin, S. S., A. S. Shiryaev, Yu V. Perov, and V. V. Khomochkin. "Clinical application evaluation of the modified of ligation intersphincteric fistula tract procedure in treatment of anal fistula." Journal of Volgograd State Medical University 21, no. 1 (2024): 178–82. https://doi.org/10.19163/1994-9480-2024-21-1-178-182.

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Background: The problem of surgical treatment of transsphincteric pararectal fistulas (TSPF) remains relevant due to the high frequency of relapses. One of the most effective methods of treatment is the operation of ligation of the fistula in the intersphincter space (LIFT), but does not exclude the possibility of a "complete" recurrence of the fistula, which requires the development of new modifications of this operation. The aim: Evaluate the results of the clinical application of the modified LIFT operation method in the treatment of TSPF. Materials and methods: The prospective cohort contr

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Garg, Pankaj, Baljit Kaur, and Geetha R. Menon. "Transanal opening of the intersphincteric space: a novel sphincter‐sparing procedure to treat 325 high complex anal fistulas with long‐term follow‐up." Colorectal Disease 23, no. 5 (2021): 1213–24. http://dx.doi.org/10.1111/codi.15555.

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Gor, I. V., A. I. Nedozimovanyi, and D. E. Popov. "Combined use of techniques of fistula ligation in the intersphincteric space and laser destruction of the fistula tract in patients with chronic paraproctitis." Grekov's Bulletin of Surgery 181, no. 5 (2022): 31–37. http://dx.doi.org/10.24884/0042-4625-2022-181-5-31-37.

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The OBJECTIVE was to improve the treatment outcomes of patients with chronic paraproctitis using the combination of minimally invasive techniques.METHODS AND MATERIALS. The treatment outcomes of 170 patients with transsphincteric anal fistulas of cryptoglandular origin were analyzed. The duration of the disease in both groups varied within 2–34 months. The main group included 85 patients operated with a combined minimally invasive method (laser destruction of the fistulous tract with subsequent ligation and its ligation in the intersphincter space), in the control group, 85 patients underwent

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Shah, Tushar P., Pratixa Hasmukhbhai Chaudhari, Niti T. Shah, and Foram P. Joshi. "An integrative approach with TROPIS, Tube in Tract and IFTAK therapy in the management of Complex Anal Fistula: An experience." Journal of Ayurveda Case Reports 7, no. 1 (2024): 42–47. http://dx.doi.org/10.4103/jacr.jacr_47_23.

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The management of complex anal fistulae is a challenging job because of the possible risk of damage to the anal sphincter leading to fecal continence, high reoccurrence rate, and delayed wound healing. Other challenges include proper drainage of the tract without disturbing anatomical alignment and painless defecation. This case presented to the outpatient department with a history of recurrent boil in the perianal region and painful pus discharge from the site for 15 days. The case was diagnosed as a case of complex fistula-in-ano and was managed by an integrative approach operative procedure

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Sun, G., Z. Lou, H. Zhang, et al. "Retrospective study of the functional and oncological outcomes of conformal sphincter preservation operation in the treatment of very low rectal cancer." Techniques in Coloproctology 24, no. 10 (2020): 1025–34. http://dx.doi.org/10.1007/s10151-020-02229-2.

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Abstract Background Conformal sphincter preservation operation (CSPO) is a new surgical procedure for very low rectal cancers (within 4–5 cm from the anal verge). CSPO preserves more of the dentate line and distal rectal wall and also avoids injuring nerves in the intersphincteric space, resulting in satisfactory anal function after resection. The aim of this study was to analyze the short-term surgical results and long-term oncological and functional outcomes of CSPO. Methods Consecutive patients with very low rectal cancer, who had CSPO between January 2011 and October 2018 at Changhai Hospi

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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.

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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. Liter

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Kostarev, I. V., A. V. Zakharyan, D. O. Kiselev, L. A. Blagodarny, A. A. Mudrov, and A. Yu Titov. "Five years of experience in using the laser coagulation method in the treatment of trans- and extrasphincter fistulas of the rectum." Koloproktologia 23, no. 1 (2024): 59–70. http://dx.doi.org/10.33878/2073-7556-2024-23-1-59-70.

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THE AIM OF the STUDY was to study the results of surgical treatment of patients with trans- and extrasphincter fistulas of the rectum using laser coagulation, depending on the method of closure of the internal fistula opening.PATIENTS AND METHODS: within the framework of scientific research conducted at the NMIC of Coloproctology named after A.N. During a 5-year period, 121 patients underwent surgical interventions using laser coagulation of the fistula passage in combination with 3 different options for closing the internal fistula opening.43 patients were included in the group of laser coagu

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Li, Yu-bo, Ju-hua Chen, Meng-di Wang, et al. "Transanal Opening of Intersphincteric Space for Fistula-in-Ano." American Surgeon, January 30, 2021, 000313482198904. http://dx.doi.org/10.1177/0003134821989048.

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Background The role of the intersphincteric space in the pathogenesis of fistula-in-ano is being increasingly recognized. Submucosal and intersphincteric rectal abscesses have been surgically managed by laying open and draining the intersphincteric space as well as by the modified ligation of intersphincteric fistula tract (LIFT) procedure. In 2017, the transanal opening of intersphincteric space (TROPIS) technique was reported for the treatment of high, complex anal fistulae. Aim We aim to investigate the advantages of performing the TROPIS procedure in patients with fistula-in-ano. Methods T

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Chen, Bo, Yueting Wang, Zubing Mei, et al. "Closed trans-intersphincteric fistulotomy: a new modified sphincter-sparing technique for high transsphincteric anal fistula." Frontiers in Surgery 11 (December 18, 2024). https://doi.org/10.3389/fsurg.2024.1487245.

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BackgroundThe main goals of surgery for fistula-in-ano are to completely resolve the condition and maintain optimal anal function. Effective management of the internal opening during and proper postoperative drainage of the intersphincter plane are crucial for achieving successful outcomes. This study evaluated the clinical efficacy of a novel sphincter-sparing technique for treating high transsphincteric anal fistula (HTAF).MethodsThis prospective study included 55 patients with HTAF who underwent closed trans-intersphincteric fistulotomy (CTiF) between July 2021 and April 2022 at our institu

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Kołodziejczak, Małgorzata, and Przemysław Ciesielski. "Hanley procedure and TROPIS method – modern therapeutic approaches in complicated anal fistulae." Nowa Medycyna 28, no. 4 (2021). http://dx.doi.org/10.25121/nm.2021.28.4.131.

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High recurrence rates after surgical management of complicated anal fistulae and concerns over postoperative incontinence encourage surgeons to look for new surgical solutions. Fistulas with high purulent reservoirs in diagnostic imaging are particularly challenging. Surgical opening of high branches and purulent reservoirs is a key therapeutic element in the management of complex fistulas. Access to these reservoirs should be established via the simplest route, hence for example, the deep postanal space should be reached from the outside by separating the external sphincter fibers, while the

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Ciesielski, Przemysław, and Małgorzata Kołodziejczak. "Wide opening of the tract of horseshoe fistulas and high intersphincteric fistulas." Nowa Medycyna 27, no. 1 (2020). http://dx.doi.org/10.25121/nm.2020.27.1.10.

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Wide surgical opening of the fistulous tract is a surgical modality that has been known for a long time. Nevertheless, the method is only used on a sporadic basis, by few surgeons, owing to the large extent of postoperative wound associated with this type of surgery, and a long healing period that may be burdensome for the patient. The surgical management of horseshoe fistulas by opening the fistulous tract and thereby exposing the deep postanal space from the posterior approach, with separation of the superficial external sphincter muscle fibers, was first described by Hanley in 1965, though

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Amin, Mohamed, Mohamed Salama, and Ahmed Saad Ahmed. "Quality of life after Abdominoperineal excision of the rectum vs intersphincteric resection in patients with low rectal malignancy." South Eastern European Journal of Public Health, February 14, 2025, 2228–41. https://doi.org/10.70135/seejph.vi.4598.

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Introduction: Intersphincteric resection of low rectal tumors is a surgical technique extending rectal resection into the intersphincteric space. This procedure is performed by a synchronous abdominoperineal approach with mesorectal excision of the entire or part of the internal sphincter.Objectives: is to evaluate the quality of life after surgery in patients with low rectal malignancy, the classic abdominoperineal resection (APR) compared to sphincter sparing (intersphincteric resection) (ISR) procedures.Methods: This was an observational clinical study at Beni-Suef University hospital in Eg

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Garg, Pankaj, Mehak Sachdeva, and Vipul D. Yagnik. "TROPIS (Transanal Opening of Intersphincteric Space) Procedure for the Treatment of Horseshoe Anal Fistulas." Journal of Gastrointestinal Surgery, June 16, 2022. http://dx.doi.org/10.1007/s11605-022-05384-z.

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Garg, Pankaj, and Baljit Kaur. "Transanal Opening of Intersphincteric Space – A Novel Procedure to Manage High Complex Anal Fistulas." Diseases of the Colon & Rectum Publish Ahead of Print (March 6, 2023). http://dx.doi.org/10.1097/dcr.0000000000002612.

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FAIER, THAIS ANDRESSA SILVA, FABIO LOPES QUEIROZ, ANTÔNIO LACERDA-FILHO, et al. "Surgical treatment of rectal cancer: prospective cohort study about good oncologic results and low rates of abdominoperineal excision." Revista do Colégio Brasileiro de Cirurgiões 50 (2023). http://dx.doi.org/10.1590/0100-6991e-20233435-en.

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ABSTRACT Objectives: the purpose of this study was to evaluate the outcome of rectal cancer surgery, in a unit adopting the principles of total mesorectal excision (TME) with a high restorative procedure rate and with a low rate of abdominoperineal excision (APE). Methods: we enrolles patients with extraperitoneal rectal cancer undergoing TME or TME+APE. Patients with mid rectal tumors underwent TME, and patients with tumors of the lower rectum and no criteria for APE underwent TME and intersphincteric resection. Those in which the intersphincteric space was invaded and in those with a free di

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Dawoud, Christopher, Moritz Daniel Felsenreich, Felix Harpain, and Stefan Riss. "Surgical Technique for Sphinkeeper® Implantation." Surgical Technology Online 43 (December 29, 2023). http://dx.doi.org/10.52198/23.sti.43.gs1712.

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Fecal incontinence is a distressing condition characterized by the involuntary loss of solid and liquid stool and gas, It affects a significant proportion of the general population, with a reported prevalence ranging from 1% to 20%. Despite its considerable impact on quality of life, therapeutic options for fecal incontinence remain limited. Current treatment modalities for fecal incontinence include conservative approaches such as dietary modifications, pelvic floor exercises, and pharmacotherapy. Surgical interventions, including sphincteroplasty or sacral nerve stimulation, may be considere

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LIANG, Xiaoxia, Xingqing LIU, Ziyang LIN, Aiwu LUO, and Xianjie WEN. "Ultrasound-guided intersphincteric space block combined with spinal anesthesia for hemorrhoidectomy: a randomized clinical trial." Minerva Anestesiologica 90, no. 4 (2024). http://dx.doi.org/10.23736/s0375-9393.24.17780-2.

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Sun, G., Y. Zang, H. Ding, et al. "Comparison of anal function and quality of life after conformal sphincter preservation operation and intersphincteric resection of very low rectal cancer: a multicenter, retrospective, case–control analysis." Techniques in Coloproctology, May 29, 2023. http://dx.doi.org/10.1007/s10151-023-02819-w.

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Abstract Purpose Conformal sphincter preservation operation (CSPO) is a sphincter preservation operation for very low rectal cancers. Compared to intersphincteric resection (ISR), CSPO retains more dentate line and distal rectal wall, and also avoids damaging the nerves in the intersphincteric space. This study aimed to compare the postoperative anal function and quality of life between the CSPO and ISR. Method Patients with low rectal cancer undergoing CSPO (n = 117) and ISR (n = 66) were included from Changhai and Huashan Hospital, respectively, between 2011 and 2020. A visual analog scale (

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Mishra, Shrivats, Dileep S. Thakur, Uday Somashekar, Amrendra Verma, and Dhananjay Sharma. "The management of complex fistula in ano by transanal opening of the intersphincteric space (TROPIS): short-term results." Annals of Coloproctology, March 31, 2023. http://dx.doi.org/10.3393/ac.2022.01018.0145.

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Iida, Yoshiro, Katuhiko Honda, Hideo Saitou, Yoshinori Munemoto, Reiko Iida, and Akiyosi Tanaka. "Sphincter-preserving total fistulectomy with resection of the anoderm and skin and intersphincteric space closure for anal fistula." Updates in Surgery, April 23, 2025. https://doi.org/10.1007/s13304-025-02195-0.

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FEI, Xu, Chunqiang WANG, Tianye HUANG, and Xuebing WANG. "Comparison of transanal opening of intersphincteric space and cutting seton for high complex anal fistula: a meta-analysis." Gazzetta Medica Italiana Archivio per le Scienze Mediche 184, no. 3 (2025). https://doi.org/10.23736/s0393-3660.24.05579-7.

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Chen, Yang-Tao, Zhao-Chu Wang, Ya-Meng Xie, et al. "Systematic review and meta-analysis of Transanal Opening of Intersphincteric Space (TROPIS) versus conventional treatments for anal fistula." Surgery Open Science, May 2025. https://doi.org/10.1016/j.sopen.2025.05.010.

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Zhou, Pengfei, Jingen Lu, Yanting Sun, and Jiawen Wang. "Transanal Opening of Intersphincteric Space (TROPIS) treatment for high complex anal fistula: a systematic review and meta-analysis." International Journal of Surgery, July 22, 2025. https://doi.org/10.1097/js9.0000000000002880.

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Background: The transanal opening of intersphincteric space (TROPIS) is a new surgical modality for treating anal fistulas. This procedure involves a transanal incision between the sphincters to promote drainage, excision of the infected areas, and maintenance of sphincter patency. In this meta-analysis, we evaluated the efficacy and safety of TROPIS in treating high complex anal fistula. Methods: We searched the PubMed (NLM), LISTA (EBSCO), and Web of Science Core Collection (Clarivate) databases for all related clinical research literature on highly complex anal fistulas treated with TROPIS

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Akalin, Çagri, Ayse Burcu Yavuzarslan, and Cihangir Akyol. "Efficacy and Safety of Endoanal Ultrasound–Guided Botulinum Toxin in Chronic Anal Fissure." American Surgeon, July 27, 2021, 000313482110347. http://dx.doi.org/10.1177/00031348211034750.

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We aimed to evaluate the efficacy and safety of endoanal ultrasound (EAUS)–guided botulinum toxin (BT) in the treatment of chronic anal fissure (CAF). All patients were classified into 2 groups: conventional and EAUS groups. In total, 90 units of BT were injected into the internal anal sphincter at the 3, 6, and 9 o’clock positions in the EAUS group. An injection was performed into the intersphincteric space at the 3, 6, and 9 o’clock positions in the conventional group. Adverse effects and efficacy were analyzed. There were 44 patients: 26 in the conventional group and 18 in the EAUS group. P

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Garg, Pankaj, and Vipul D. Yagnik. "The Efficacy of Transanal Opening of Intersphincteric Space Procedure in High Complex Anal Fistulas on Long-term Follow-up." American Surgeon, April 13, 2021, 000313482110110. http://dx.doi.org/10.1177/00031348211011092.

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Qin, Jiawei, Yanlan Wu, Xueping Zheng, et al. "Comparative Evaluation Between Cutting of the Intersphincteric Space vs Cutting Seton in High Anal Fistula: A Randomized Controlled Trial." Journal of the American College of Surgeons, August 21, 2024. http://dx.doi.org/10.1097/xcs.0000000000001192.

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Background: This study compared the efficacy of cutting of the intersphincteric space (COIS) with cutting seton (CS) procedure in treating high anal fistula. Methods: Patients diagnosed with high anal fistula were allocated into groups, who randomly received COIS and CS procedures. The primary outcome was wound healing time. Secondary outcomes included surgical parameters (operation time, hospital stay, and hospitalization expense), anal sphincter function, wound pain, wound size, clinical efficacy, recurrence after 12 months of follow-up, and complications. Results: A total of 72 patients par

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Wang, Chunqiang, Tianye Huang, and Xuebing Wang. "Efficacy and safety of transanal opening of intersphincteric space in the treatment of high complex anal fistula: A meta‑analysis." Experimental and Therapeutic Medicine 28, no. 2 (2024). http://dx.doi.org/10.3892/etm.2024.12595.

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Garg, Pankaj, and Anvesha Mongia. "Transanal opening of the intersphincteric space (TROPIS): a novel procedure on the horizon to effectively manage high complex anal fistulas." Annals of Coloproctology, October 24, 2023. http://dx.doi.org/10.3393/ac.2022.01263.0180.

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Li, Zhengbiao, Qi Wang, Qingbo Feng, Xingqin Wang, Fujian Xu, and Ming Xie. "Laparoscopic intersphincteric resection vs. transanal total mesorectal excision in overweight patients with low rectal cancer." Frontiers in Surgery 9 (October 6, 2022). http://dx.doi.org/10.3389/fsurg.2022.984680.

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ObjectiveAnus-preserving surgery in overweight patients with low rectal cancer has been a challenge due to the narrow operating space. Intersphincteric resection (ISR) was once a standard therapeutic option for low rectal cancer. The effectiveness of transanal total mesorectal excision (taTME) in treating this group of patients remains uncertain as a new surgical strategy. The aim of this study was to evaluate the short-term effects of taTME with ISR in overweight patients with low rectal cancer.MethodsA total of 53 patients with low rectal cancer were treated with taTME in 31 cases and ISR in

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Garg, Pankaj, Nicola Clemente, and James C. W. Khaw. "Transanal Opening of the Intersphincteric Space (TROPIS) Is Effective in Managing High Complex as It Is Based on Garg Cardinal Principles." Digestive Diseases and Sciences, March 20, 2025. https://doi.org/10.1007/s10620-025-08980-6.

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Sun, Yanting, Yang Liu, Pengfei Zhou, Meifeng Yang, and Jiawen Wang. "Transanal Opening of the Intersphincteric Space (TROPIS) for Managing High Complex Perianal Fistula in a Crohn’s Disease Case with Anorectal Stenosis." Digestive Diseases and Sciences, February 18, 2025. https://doi.org/10.1007/s10620-025-08859-6.

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Huang, Baolei, Xu Wang, Dongxu Zhou, et al. "Treating highly complex anal fistula with a new method of combined intraoperative endoanal ultrasonography (IOEAUS) and transanal opening of intersphincteric space (TROPIS)." Videosurgery and Other Miniinvasive Techniques, 2021. http://dx.doi.org/10.5114/wiitm.2021.104368.

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Liu, Yang, Yanting Sun, Pengfei Zhou, and Jiawen Wang. "Transanal Opening of the Intersphincteric Space (TROPIS) Combined with Suture-Dragging for Complex Rectovaginal Fistula (RVF) with Anorectal Stenosis in Crohn’s Disease." Digestive Diseases and Sciences, March 12, 2025. https://doi.org/10.1007/s10620-025-08967-3.

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Hieda, Keisuke, Kwang Ho Cho, Takashi Arakawa, Mineko Fujimiya, Gen Murakami, and Akio Matsubara. "Nerves in the intersphincteric space of the human anal canal with special reference to their continuation to the enteric nerve plexus of the rectum." Clinical Anatomy, March 2013, n/a. http://dx.doi.org/10.1002/ca.22227.

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Zhang, Danfeng, Yanting Sun, and Jiawen Wang. "Transanal Opening of the Intersphincteric Space (TROPIS): Combined with Suture-Dragging for Treating of Rectovaginal and Perianal Fistulas in Crohn’s Disease with Anorectal Stricture." Digestive Diseases and Sciences, April 28, 2025. https://doi.org/10.1007/s10620-025-09059-y.

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-, Shubhangi, and Shilpa P. N. -. "Clinical Study of Dashanga Lepa Application Followed by Virechana Karma in the Management of Guda Vidradi (Recurrent Perinal Abscess)." International Journal For Multidisciplinary Research 5, no. 5 (2023). http://dx.doi.org/10.36948/ijfmr.2023.v05i05.5354.

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The phenomenon of formation of wound as a result of inflammation and abscess. Its repair and treatment by mean of Shasti upakrama or saptopakrama is the fundamental major contribution of acharya Sushruta. An ano rectal abscess originates from an infection arising in the crypto-glandular epithelium lining of the anal canal spreading into adjacent spaces and resulting in fistula, in 40% of cases. The classic location of anorectal abscess, listed in order of decreasing frequency are as follows: perianal (60%), ischiorectal (20%), intersphincteric (5%), supralevator (4%) and submucosal (1%). The t

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