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https://www.readbyqxmd.com/read/29651553/fistulectomy-with-primary-sphincter-reconstruction
#1
Steffen Seyfried, Dieter Bussen, Andreas Joos, Christian Galata, Christel Weiss, Alexander Herold
AIM: Despite modern medical techniques, anatomically proximal (high) anal fistulas are still a challenge in colorectal surgery. In previous years, the standard of care was complete fistulectomy with a high rate of continence disorders. Over the past 20 to 30 years, sphincter-saving procedures have gained wide acceptance. They represent the technique used in these cases. Additionally, many patients received indefinite treatment, namely the placement of a seton to maintain surgical drainage...
April 12, 2018: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/29618340/3d-high-resolution-anorectal-manometry-in-patients-with-perianal-fistulas-comparison-with-3d-anal-ultrasound
#2
Richelle J F Felt-Bersma, Maarten S Vlietstra, Paul F Vollebregt, Ingrid J M Han-Geurts, Vera Rempe-Sorm, Grietje J H Vander Mijnsbrugge, Charlotte B H Molenaar
BACKGROUND: Perianal fistula surgery can damage the anal sphincters which may cause faecal incontinence. By measuring regional pressures, 3D-HRAM potentially provides better guidance for surgical strategy in patients with perianal fistulas. The aim was to measure regional anal pressures with 3D-HRAM and to compare these with 3D-EUS findings in patients with perianal fistulas. METHODS: Consecutive patients with active perianal fistulas who underwent both 3D-EUS and 3D-HRAM at a clinic specialised in proctology were included...
April 4, 2018: BMC Gastroenterology
https://www.readbyqxmd.com/read/29608959/clinical-diagnostic-and-therapeutic-aspects-of-221-consecutive-anorectal-chlamydia-trachomatis-and-neisseria-gonorrhoeae-sexually-transmitted-infections-among-men-who-have-sex-with-men
#3
J Lourtet Hascoet, M Dahoun, M Cohen, E Pommaret, B Pilmis, N Lemarchand, A Mizrahi, M Aubert, V de Parades, A Le Monnier
OBJECTIVES: Proctitis caused by Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) are known as sexually transmitted infections (STI). This study describes their clinical, diagnostic and therapeutic aspects. METHODS: Between 01/2013-03/2015, all MSM consulting for proctitis at proctology Institute-Saint-Joseph's Hospital, Paris, were included. Demographic, past-medical history, STI status and medical treatment were collected. Detection of CT/NG was performed by Transcription-Mediated Amplification (TMA) and antimicrobial susceptibilities for Ng by agar diffusion method...
March 30, 2018: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/29593864/laparoscopic-abdominoperineal-resection-for-the-treatment-of-a-mucinous-adenocarcinoma-associated-with-an-anal-fistula
#4
Dimosthenis Chrysikos, Theodoros Mariolis-Sapsakos, Tania Triantafyllou, Vasileios Karampelias, Apostolos Mitrousias, George Theodoropoulos
Mucinous adenocarcinoma associated with an anal fistula is a rare oncologic entity which may pose diagnostic and therapeutic challenges for Surgeons and Medical Oncologists. Few reported cases without definite therapeutic guidelines exist. It represents 2-3% of all gastrointestinal malignancies and arises from chronic anal fistulas, ischiorectal or perianal abscesses. We report a case of perianal mucinous adenocarcinoma in a 65-year-old male initially surgically treated multiple times for a recurrent fistula in ano of 5 years duration...
March 2018: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/29588261/complete-penile-duplication-with-structurally-normal-penises-a-case-report
#5
Ahsen Karagözlü Akgül, Murat Uçar, Fatih Çelik, İrfan Kırıştıoğlu, Nizamettin Kılıç
BACKGROUND: Diphallia is a very rare anomaly and seen once in every 5.5 million live births. True diphallia with normal penile structures is extremely rare (1,2,3,4,5,6,7). We present the surgical management of a 4-year-old patient with complete penile duplication without any penile or urethral pathology. CASE REPORT: The patient's first physical examination revealed complete penile duplication, urine flow from both penises, meconium flow from right urethra, and anal atresia...
March 28, 2018: Balkan Medical Journal
https://www.readbyqxmd.com/read/29575180/sonographic-assessment-of-the-anal-sphincter-after-obstetric-anal-sphincter-injury-oasi-using-transperineal-ultrasound-tpus
#6
EDITORIAL
Vered H Eisenberg, Dan V Valsky, Simcha Yagel
Obstetric anal sphincter injury (OASI) is the most common cause of anal incontinence and ano-rectal symptoms in women1 . Reported rates of anal incontinence following primary repair of OASI range between 15-61%, with a mean of 39%2, 3 . Other possible complications of OASI include perineal pain, dyspareunia, and less commonly, abscess formation, wound breakdown, and rectovaginal fistulae. Symptom onset may occur immediately, several years postpartum, or only late in life when aging of tissues adds to the delivery insult...
March 24, 2018: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/29569419/patients-with-perianal-crohn-s-fistulae-experience-delays-in-accessing-anti-tnf-therapy-due-to-slow-recognition-diagnosis-and-integration-of-specialist-services-lessons-learned-from-three-referral-centres
#7
Matthew J Lee, Clare Freer, Sam Adegbola, Soad Elkady, Miles Parkes, Ailsa Hart, Nicola S Fearnhead, Alan J Lobo, Steven R Brown
BACKGROUND: Crohn's anal fistula should be managed with a multidisciplinary team. There is no clearly defined 'patient pathway' from presentation to treatment. The aim of this study was to describe the patient route from presentation with symptomatic Crohn's anal fistula to starting anti-TNF therapy. METHOD: Case note review was undertaken at three hospitals with established IBD services. Patients with Crohn's anal fistula presenting between 2010 and 2015 were identified through clinical coding and local databases...
March 22, 2018: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/29525123/treatment-of-fistula-in-ano-with-otsc-%C3%A2-proctology-clip-device-short-term-results
#8
Franco Marinello, Miquel Kraft, Nuria Ridaura, Francesc Vallribera, Eloy Espín
INTRODUCTION: The treatment of anal fistula with the OTSC® (over-the-scope-clip) proctology device involves the placement of an elastic alloy clip called Nitinol on the internal fistula opening to achieve fistula healing. The aim of this study was to analyze preliminary results of this technique in a case series. METHODS: This was a retrospective analysis of patients who underwent OTSC® clip placement for fistula-in-ano treatment between June 2015 and March 2017 at a specialized colorectal unit...
March 7, 2018: Cirugía Española
https://www.readbyqxmd.com/read/29521832/draining-setons-as-definitive-management-of-fistula-in-ano
#9
Oluwatomilayo O Daodu, Julia O'Keefe, John A Heine
BACKGROUND: The ideal management for fistula-in-ano would resolve the disease while preserving anal continence. OBJECTIVE: The purpose of this study was to determine the efficacy of draining seton alone in achieving resolution or significant amelioration of symptoms for patients with fistula-in-ano. DESIGN: This was a retrospective case series involving chart review and telephone interviews. A single colorectal surgeon performed surgeries between June 1, 2005, and June 30, 2014...
April 2018: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/29521831/stapled-hemorrhoidopexy-results-at-10-year-follow-up
#10
Gabriele Bellio, Arianna Pasquali, Michele Schiano di Visconte
BACKGROUND: Despite the advantages of stapled hemorrhoidopexy reported in the literature in terms of postoperative pain, hospital stay, and duration of convalescence, it was described to have a higher recurrence rate compared with conventional hemorrhoidectomy. OBJECTIVE: The aim of this study was to evaluate clinical outcomes and patient satisfaction after stapled hemorrhoidopexy at 10-year follow-up. DESIGN: This was a retrospective cohort analysis conducted on prospectively collected data...
April 2018: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/29511136/one-or-two-stages-procedure-for-repair-of-rectovestibular-fistula-which-is-safer-a-single-institution-experience
#11
Mohammed Khalifa, Khalid Shreef, Mohammad Ahmad Al Ekrashy, Tarek Abdelazim Gobran
Background: Rectovestibular fistula (RVF) is the most common type of anorectal malformations in females. The need for a diverting colostomy during correction of defect has ignited a heated debate. In this study, we reviewed the girls with RVF that had been treated by either one or two stage procedure in the past 10 years in our institution to define whether one stage or two stage procedures is safer and more beneficial for the patients. Materials and Methods: Seventy girls with RVF that had been operated from January 2005 to January 2015 were studied retrospectively...
April 2017: African Journal of Paediatric Surgery: AJPS
https://www.readbyqxmd.com/read/29505533/familial-mediterranean-fever-mimicking-crohn-disease-a-case-report
#12
Kensuke Asakura, Shunichi Yanai, Shotaro Nakamura, Keisuke Kawaski, Makoto Eizuka, Kazuyuki Ishida, Masaki Endo, Tamotsu Sugai, Kiyoshi Migita, Takayuki Matsumoto
RATIONALE: Familial Mediterranean fever (FMF) is the most common form of autoinflammatory disease. We report a rare case of FMF with gastrointestinal lesions mimicking Crohn disease. PATIENT CONCERNS: A 21-year-old Japanese man was referred to our institution, complaining of refractory diarrhea and weight loss of 14 kg during the past two years. He had presented with recurrent fever, abdominal pain, anal fistula and stomatitis. His father and one of his brothers had ulcerative colitis...
January 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29481992/the-clinical-application-of-a-silicate-based-wound-dressing-dermfactor-%C3%A2-for-wound-healing-after-anal-surgery-a-randomized-study
#13
Shuo Chen, Zhiguang Huan, Lin Zhang, Jiang Chang
BACKGROUND: The object of the present study is to evaluate the feasibility of a silicate-based wound dressing (DermFactor® ) in treating the wound of the patients after anorectal surgery. MATERIALS AND METHODS: The present study included 328 patients who received anal surgery during the period from March 2013 to June 2015. The patients were randomized to 2 groups. The patients (n = 162) in the control group received conventional dressing therapy, while those in the observation group (n = 166) were treated with the combination of conventional dressing therapy and the use of a silicate-based wound dressing (DermFactor® )...
February 23, 2018: International Journal of Surgery
https://www.readbyqxmd.com/read/29464744/primary-peri-anal-adenocarcinoma-of-intestinal-type-a-new-proposed-entity
#14
Pelvender S Gill, Newton A C S Wong
AIMS: The currently recognised subtypes of anal canal/peri-anal adenocarcinoma are those arising from low rectal mucosa or columnar cuff, fistula-related tumours and anal gland carcinoma. This report presents two examples of a hitherto undescribed subtype of peri-anal adenocarcinoma with an intestinal phenotype. METHODS AND RESULTS: A 74-year-old man had a peri-anal tumour locally excised, whereas a 73-year-old female underwent an abdominoperineal resection for peri-anal Paget's disease with an underlying carcinoma...
February 21, 2018: Histopathology
https://www.readbyqxmd.com/read/29453515/micro-fragmented-adipose-tissue-injection-for-the-treatment-of-complex-anal-fistula-a-pilot-study-accessing-safety-and-feasibility
#15
G Naldini, A Sturiale, B Fabiani, I Giani, C Menconi
BACKGROUND: The aim of the present study was to evaluate the safety and efficacy of autologous, micro-fragmented and minimally manipulated adipose tissue injection associated closure of the internal opening in promoting healing of complex anal fistula. METHODS: A pilot study was conducted on patients referred to our center with anal fistula, from April 2015-December 2016. Inclusion criteria were age over 16 years old and a diagnosis of complex anal fistula according to the American Gastroenterological Association classification The patients were divided into 2 groups; the "first time group" (Group I) in which micro-fragmented adipose tissue injection with closure of the internal opening was the first sphincter-saving procedure, and the "recurrent group" (Group II) consisting of patients who had failed prior sphincter-saving procedures...
February 2018: Techniques in Coloproctology
https://www.readbyqxmd.com/read/29452968/analysis-and-description-of-disease-specific-quality-of-life-in-patients-with-anal-fistula
#16
Manuel Ferrer-Márquez, Natalia Espínola-Cortés, Ángel Reina-Duarte, José Granero-Molina, Cayetano Fernández-Sola, José Manuel Hernández-Padilla
INTRODUCTION: In patients diagnosed with anal fistula, knowing the quality of life specifically related to the disease can help coloproctology specialists to choose the most appropriate therapeutic strategy for each case. The aim of our study is to analyzse and describe the factors related to the specific quality of life in a consecutive series of patients diagnosed with anal fistula. METHODS: Observational, cross-sectional study carried out from March 2015 to February 2017...
February 13, 2018: Cirugía Española
https://www.readbyqxmd.com/read/29442064/pilonidal-disease-mimicking-anterior-anal-fistula-and-associated-with-posterior-anal-fistula-a-two-step-surgery-case-report
#17
Chiara Eberspacher, D Mascagni, L Fralleone, G Grimaldi, P Antypas, P Mascagni, A Maturo, F M Di Matteo, S Pontone, D Pironi
AIM: Anal fistula is a common disease originated from abscess according the cryptoglandular theory. A rare etiology is the pilonidal disease. In our case we observed a pilonidal disease mimicking an anterior perianal fistula, associated with another posterior anal fistula. CASE PRESENTATION: A 36-year old man was referred to our department with an anal fistula with an anterior opening. Despite the clinical examination and the endoanal ultrasound, only during the surgery we discovered the origin of the anterior fistula from a misdiagnosed pilonidal sinus...
November 2017: Il Giornale di Chirurgia
https://www.readbyqxmd.com/read/29411947/silk-fibroin-based-fibrous-anal-fistula-plug-with-drug-delivery-function
#18
Xusheng Xie, Lei Liu, Zhaozhu Zheng, Zhifen Han, Min Zhi, David L Kaplan, Gang Li, Xiaoqin Wang
The aim of this work is to develop a drug-loaded silk fibroin fibrous membrane (DSFM) that can be attached to the surface of an anal fistula plug to improve the treatment of Crohn's disease (CD). Curcumin (CUR) and 5-aminosalicylic acid (5-ASA)-loaded silk fibroin (SF) membranes are coaxially electrospun onto the surface of a braided silk filament plug. The membranes show a predominant structure of random coil and silk I conformation. The concentration of CUR/5-ASA (weight ratio of 1/1) in the SF solution is optimized to 0...
February 7, 2018: Macromolecular Bioscience
https://www.readbyqxmd.com/read/29397638/otsc%C3%A2-proctology-vs-fistulectomy-and-primary-sphincter-reconstruction-as-a-treatment-for-low-trans-sphincteric-anal-fistula-in-a-randomized-controlled-pilot-trial
#19
Domenico Mascagni, Daniele Pironi, Gianmarco Grimaldi, Anna M Romani, Giuseppe LA Torre, Chiara Eberspacher, Rossella Palma, Salvatore Sorrenti, Stefano Pontone
BACKGROUND: To compare OTSC® Proctology and fistulectomy with primary sphincter reconstruction results as treatment strategies for anorectal low trans-sphincteric fistula. METHODS: Between February 2012 and March 2013, patients affected by trans-sphincteric anal fistula were consecutively enrolled in the trial. Patients were randomized to receive fistulectomy with primary sphincter reconstruction or OTSC® Proctology. Demographic characteristics, comorbodities, previous anorectal treatments, and recurrent fistula data were acquired...
February 1, 2018: Minerva Chirurgica
https://www.readbyqxmd.com/read/29394765/-a-case-of-more-than-five-year-survival-of-carcinoma-associated-with-anal-fistula-effectively-treated-by-combined-modality-therapy
#20
Mizunori Yaegashi, Koki Otsuka, Toshimoto Kimura, Teppei Matsuo, Kei Sato, Kiyoharu Takashimizu, Tomoki Hatanaka, Toru Yoshida, Chihiro Tono, Yukihiro Minagawa, Masanori Takahashi, Hideki Ishioka, Ryo Sugimoto, Tamotsu Sugai, Akira Sasaki
The patient was a 56-year-old man who presented with perianal pain and a perianal abscess. After admission, he underwent debridement and colostomy due to poor control of the perianal abscess. Following a biopsy of the resected specimens, he was diagnosed with adenocarcinoma in the anorectal fistula. CT and MRI revealed that the tumor had invaded into the internal obturator muscle. Therefore, preoperative chemoradiotherapy and chemotherapy were given for locally advanced cancer. Subsequent to tumor shrinkage, we performed an abdominoperineal resection...
November 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
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