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https://www.readbyqxmd.com/read/28337531/advancement-flap-for-treatment-of-complex-cryptoglandular-anal-fistula-prediction-of-therapy-success-or-failure-using-anamnestic-and-clinical-parameters
#1
Lars Boenicke, Eduard Karsten, Hubert Zirngibl, Peter Ambe
BACKGROUND: Multiple new procedures for treatment of complex anal fistula have been described in the past decades, but an ideal single technique has yet not been identified. Factors that predict the outcome are required to identify the best procedure for each individual patient. The aim of this study was to find those predictors for advancement flap at midterm follow-up. METHODS: From 2012 to 2015 in a tertiary university clinic, all patients who underwent advancement flap for treatment of complex cryptoglandular fistula were prospectively enrolled...
March 23, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28333258/anal-neoplasia-in-inflammatory-bowel-disease-classification-proposal-epidemiology-carcinogenesis-and-risk-management-perspectives
#2
Andrew Wisniewski, Jean-Francois Fléjou, Laurent Siproudhis, Laurent Abramowitz, Magali Svrcek, Laurent Beaugerie
Patients with inflammatory bowel disease (IBD) may develop, similarly to individuals from general population, rare cases of HPV-related anal canal squamous cell carcinoma (SCC) and their intra-epithelial precursor lesions, as well as very rare cases of anal canal adenocarcinoma. Patients with chronic perianal Crohn's disease (CD) are at substantial risk of developing SCC or adenocarcinoma from the fistula-lining epithelium, as well as SCC or adenocarcinoma arising from chronic anorectal ulcerations or strictures...
March 10, 2017: Journal of Crohn's & Colitis
https://www.readbyqxmd.com/read/28302173/squamous-cell-carcinoma-arising-from-chronic-sacrococcygeal-pilonidal-disease-a-case-report
#3
Nick Michalopoulos, Konstantinos Sapalidis, Styliani Laskou, Evangelia Triantafyllou, Georgia Raptou, Isaak Kesisoglou
BACKGROUND: Sacrococcygeal pilonidal disease is a chronic, well-recognized entity, characterized by the recurrent formation of an abscess or draining sinus over the sacrococcygeal area. It is one of the most common surgical problems. Rarely, chronic inflammation and recurrent disease leads to malignant transformation, most commonly to squamous cell carcinoma (SCC). CASE PRESENTATION: We describe an extremely unusual case of SCC developing in a 60-year-old patient with a chronic pilonidal sinus complicated by an anal fistula...
March 17, 2017: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28301429/results-at-up-to-30-years-after-ileal-pouch-anal-anastomosis-for-chronic-ulcerative-colitis
#4
Amy L Lightner, Kellie L Mathis, Eric J Dozois, Dieter Hahnsloser, Edward V Loftus, Laura E Raffals, John H Pemberton
BACKGROUND: Ileal pouch-anal anastomosis (IPAA) has become the surgical procedure of choice for patients with chronic ulcerative colitis. No study to date has examined functional and quality-of-life outcomes 30 years after pouch construction. METHODS: Using data from a prospectively maintained database with annually distributed questionnaires, functional outcomes, pouch complications, and quality of life after IPAA were determined. RESULTS: Overall, 93...
March 15, 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28291300/-possible-relation-between-antenatal-venlafaxine-use-and-vacterl-association-in-a-newborn-a-case-report
#5
Muammer Özgür Çevik, Mustafa Çelik, İbrahim Hakan Bucak, Behice Han Almış, Mehmet Turğut
Major depressive disorder is common during antenatal period and many women are prescribed antidepressant drugs despite no antidepressant can be regarded as definitely safe in pregnancy. Previous studies have suggested links between gestational use of selective serotonin reuptake inhibitors (SSRI) or serotonin and norepinephrine reuptake inhibitors (SNRI) and certain birth defects. VACTERL association is a rare group of congenital malformations which were observed to occur together more often than would be expected by chance...
2017: Türk Psikiyatri Dergisi, Turkish Journal of Psychiatry
https://www.readbyqxmd.com/read/28290968/management-of-post-traumatic-rectovesical-rectourethral-fistulas-case-series-of-complicated-injuries-in-wounded-warriors-and-review-of-the-literature
#6
Walter B Kucera, James R Jezior, James E Duncan
INTRODUCTION: Penetrating injuries to the pelvis and perineum can result in fistulas between the rectum and lower urinary tract. These injuries are often complicated, which creates challenges for successful repair. Operative strategies may include initial fecal and/or urinary diversion combined with an eventual trans-perineal, trans-anal, or posterior/transrectal approach, but the selected approach should be guided by precise anatomic localization of the injury. We aim to discuss different possible repair strategies as well as the relevant data surrounding gastrointestinal-genitourinary (GI-GU) fistula management...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28289973/a-novel-laparoscopic-technique-for-anorectal-malformation-with-low-recto-bulbar-fistulae
#7
Mei Diao, Long Li, Kao-Ping Guan, Zhen Zhang, Wei Cheng
BACKGROUND: The repair of anorectal malformation (ARM) with low recto-bulbar fistula (bowel-to-skin distance: 1-1.5 cm) is contraindicated for laparoscopy due to the difficulty in exposing the fistulae. Posterior or anterior sagittal anorectoplasty is thus conventionally carried out for low recto-bulbar fistula repair. However, these procedures carry the potential risk of wound infection/dehiscence and incontinence. We have developed a single-incision laparoscopic-assisted perineal anorectoplasty (SILPARP) technique...
March 13, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28289661/early-experience-with-a-partial-stapled-hemorrhoidopexy-for-treating-patients-with-grades-iii-iv-prolapsing-hemorrhoids
#8
Hyeonseok Jeong, Sunghwan Hwang, Kil O Ryu, Jiyong Lim, Hyun Tae Kim, Hye Mi Yu, Jihoon Yoon, Ju-Young Lee, Hyoung Rae Kim, Young Gil Choi
PURPOSE: Circular stapled hemorrhoidopexy (CSH) is widely used to treat patients with grades III-IV hemorrhoids because of less pain and short hospital stay. However, this procedure is associated with some complications, such as urge to defecate, anal stenosis, staple line dehiscence, abscess and sepsis. To avoid these complications, surgeons perform a partial stapled hemorrhoidopexy (PSH). The aim of this study is to present our early experience with the PSH. METHODS: We retrospectively reviewed the medical records of 58 patients with hemorrhoids who were treated with a PSH at Busan Hang-Un Hospital from January 2016 to June 2016...
February 2017: Annals of Coloproctology
https://www.readbyqxmd.com/read/28271331/five-years-of-experience-with-the-filac%C3%A2-laser-for-fistula-in-ano-management-long-term-follow-up-from-a-single-institution
#9
A Wilhelm, A Fiebig, M Krawczak
BACKGROUND: There are limited data available concerning endofistular therapies for fistula-in-ano, with our group reporting the first preliminary outcomes of the use of the radial fibre Fistula laser Closing (FiLaC ™) device. METHODS: The aim of this study was to assess a cohort of anal fistulae managed with laser ablation plus definitive flap closure of the internal fistula opening over a long-term follow-up. Factors governing primary healing success and secondary healing success (i...
March 7, 2017: Techniques in Coloproctology
https://www.readbyqxmd.com/read/28271064/ligation-of-intersphincteric-fistula-tract-is-suitable-for-recurrent-anal-fistulas-from-follow-up-of-16-months
#10
Yansong Xu, Weizhong Tang
Since 2007, ligation of the intersphincteric fistula tract (LIFT) for the management of anal fistula was all introduced with initial success and excitement. It remains controversial which surgical procedure is suitable for transsphincteric fistula, especially to complex anal fistula. This retrospective study was designed to evaluate the results in patients with recurrent anal fistula by LIFT. A retrospective study of 55 complex fistula patients who underwent LIFT procedure in a single medical center was analyzed...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28260712/a-case-of-turner-syndrome-46xxp-45x-complicated-with-crohn-s-disease-after-hormone-therapy
#11
Yutaro Ihara, Kazuoki Hizawa, Kouhei Fujita, Masahiro Iida, Ema Washio, Takahiro Kai, Tomoki Nitahata, Motohiro Esaki, Mitsuo Iida
A 19-year-old woman, who had been receiving hormone replacement therapy for 13 months before the diagnosis of mosaic Turner syndrome (46XXp-/45X), developed Crohn's colitis and erythema nodosum of the lower legs. Colonoscopy revealed an anal fistula and the presence of deep longitudinal ulcers with cobblestoning in the colorectum. Therapy with prednisolone and adalimumab was effective for the intestinal and skin lesions. To date, all seven case reports of Turner syndrome in Japan have also developed Crohn's disease after hormone therapy, suggesting a possible association of sex hormones in the pathogenesis...
2017: Nihon Shokakibyo Gakkai Zasshi, the Japanese Journal of Gastro-enterology
https://www.readbyqxmd.com/read/28259693/transanal-opening-of-intersphincteric-space-tropis-a-new-procedure-to-treat-high-complex-anal-fistula
#12
Pankaj Garg
BACKGROUND: The sepsis in intersphincteric space has important role in pathogenesis of most complex fistula-in-ano. This sepsis is like a small abscess in a closed space. This closed space needs to be drained adequately and then kept open for the fistula-in-ano to heal properly. The aim was to lay open and drain the intersphincteric space through internal opening via transanal approach. This has been tried in submucosal and intersphincteric rectal abscesses but has never been tried in complex fistula-in-ano...
March 1, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28253730/endoscopic-colostomy-with-percutaneous-colopexy-an-animal-feasibility-study
#13
Leonardo Alfonso Bustamante-Lopez, Marianny Sulbaran Nava, Sergio Carlos Nahas, Eduardo Guimaraes Horneaux de Moura, Caio Sergio Nahas, Carlos Frederico Sparapam Marques, Christiano Sakai, Ivan Cecconello, Paulo Sakai
BACKGROUND: Indications for colostomy in colorectal diseases are obstruction of the large bowel, such as in cancer, diverticular disease in the acute phase, post-radiotherapy enteritis, complex perirectal fistulas, anorectal trauma and severe anal incontinence. Some critically ill patients cannot tolerate an exploratory laparotomy, and laparoscopic assisted colostomy also requires general anesthesia. OBJECTIVE: To evaluate the feasibility, safety and efficacy of performing colostomy assisted by colonoscopy and percutaneous colopexy...
March 3, 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28251361/german-s3-guidelines-anal-abscess-and-fistula-second-revised-version
#14
Andreas Ommer, Alexander Herold, Eugen Berg, Alois Fürst, Stefan Post, Reinhard Ruppert, Thomas Schiedeck, Oliver Schwandner, Bernhard Strittmatter
BACKGROUND: The incidence of anal abscess and fistula is relatively high, and the condition is most common in young men. METHODS: This is a revised version of the German S3 guidelines first published in 2011. It is based on a systematic review of pertinent literature. RESULTS: Cryptoglandular abscesses and fistulas usually originate in the proctodeal glands of the intersphincteric space. Classification depends on their relation to the anal sphincter...
March 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/28250903/endoscopic-closure-instead-of-surgery-to-close-an-ileal-pouch-fistula-with-the-over-the-scope-clip-system
#15
Yao Wei, Jian-Feng Gong, Wei-Ming Zhu
An ileal pouch fistula is an uncommon complication after an ileal pouch anal anastomosis. Most patients who suffer from an ileal pouch fistula will need surgical intervention. However, the surgery can be invasive and has a high risk compared to endoscopic treatment. The over-the-scope clip (OTSC) system was initially developed for hemostasis and leakage closure in the gastrointestinal tract during flexible endoscopy. There have been many successes in using this approach to apply perforations to the upper gastrointestinal tract...
February 16, 2017: World Journal of Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28247060/rectal-advancement-flap-for-the-treatment-of-complex-cryptoglandular-anal-fistulas-a-systematic-review-and-meta-analysis
#16
REVIEW
Zutoia Balciscueta, Natalia Uribe, Izaskun Balciscueta, Juan Carlos Andreu-Ballester, Eduardo García-Granero
PURPOSE: Rectal advancement flap is an accepted approach for treating complex fistula-in-ano. However, a diversity of technical modifications have been described. The aim of this study was to evaluate recurrence and fecal continence rates after performing rectal advancement flaps depending upon flap thickness (full-thickness, partial-thickness, or mucosal flaps) and treatment of the fistulous tract (core-out or curettage). METHODS: Medline (PubMed, Ovid), the Cochrane Library database, and ClinicalTrials...
February 28, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28237945/rare-association-of-congenital-penile-urethrocutaneous-fistula-with-y-type-urethral-duplication
#17
Ashok Kumar Gupta, Manoj Kumar, Kawaljit Singh, Ashok Kumar Sokhal
A 24-year-old man presented with symptoms of difficulty in passage of urine, mixed with gas and stool from penoscrotal junction since birth. He had a history of surgery (posterior sagittal anorectoplasty) for imperforate anus in first week of his life. On physical examination, external meatus was adequate with small 5×5 mm fistulous opening noted at penoscrotal junction with normal anal tone and opening. On evaluation with retrograde urethrography, voiding cystourethrogram, cystoscopy and barium enema, he was found to have penile urethrocutaneous fistula of 0...
February 24, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28228247/the-changes-in-resting-anal-pressure-after-performing-full-thickness-rectal-advancement-flaps
#18
Zutoia Balciscueta, Natalia Uribe, Miguel Mínguez, Eduardo García-Granero
BACKGROUND: Advancement flap is an accepted approach for treating complex fistula-in-ano.The purpose was to evaluate the changes in resting pressure along the anal canal after performing a full-thickness flap. METHODS: Manometric review of patients who have undergone a full-thickness rectal advancement flap procedure for complex anal fistulas of cryptoglandular origin. Recurrence and continence were evaluated. Resting Anal Pressure was assessed along the anal canal by two measures: maximum resting pressure(MRP) and inferior resting pressure(IRP) at 0...
January 10, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28218881/mr-imaging-of-perianal-crohn-disease
#19
Shannon P Sheedy, David H Bruining, Eric J Dozois, William A Faubion, Joel G Fletcher
Pelvic magnetic resonance (MR) imaging is currently the standard for imaging perianal Crohn disease. Perianal fistulas are a leading cause of patient morbidity because closure often requires multimodality treatments over a prolonged period of time. This review summarizes clinically relevant anal sphincter anatomy, imaging methods, classification systems, and treatment objectives. In addition, the MR appearance of healing perianal fistulas and fistula complications is described. Difficult imaging tasks including the assessment of rectovaginal fistulas and ileoanal anastomoses are highlighted, along with illustrative cases...
March 2017: Radiology
https://www.readbyqxmd.com/read/28217872/craniosynostosis-delayed-closure-of-the-fontanelle-anal-genitourinary-and-skin-abnormalities-cdags-syndrome-first-report-in-a-mexican-patient-and-review-of-the-literature
#20
Rodrigo Pastrana-Ayala, Gretty L Peña-Castro, Adriana M Valencia-Herrera, Carlos A Mena-Cedillos, Sonia Toussaint-Caire, Yumiko I Akaki-Carreño, Constanza García-Delgado, Veronica F Morán-Barroso, Mirna Toledo-Bahena
INTRODUCTION: Craniosynostosis and clavicular hypoplasia, delayed closure of the fontanelle, cranial defects, anal and genitourinary abnormalities, and skin (CDAGS), is an infrequent autosomal recessive entity with only 10 cases reported; no associated gene has been identified so far. CASE REPORT: The proband is a 2-year-old Mexican female with brachycephaly, cleft palate, anal malformation with rectovestibular fistula, and clinodactyly of the third toe overlapping the second...
February 19, 2017: International Journal of Dermatology
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