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Fistula in ano

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
Pankaj Garg
No abstract text is available yet for this article.
April 2018: Diseases of the Colon and Rectum
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
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
K S Chapple, J Purves, P Metherall, R de Noronha
No abstract text is available yet for this article.
December 2017: Techniques in Coloproctology
Umesh Jayarajah, Dakshitha Praneeth Wickramasinghe, Dharmabandhu Nandadeva Samarasekera
BACKGROUND: Anal incontinence is a known complication following operative treatment of fistula-in-ano which can significantly impact the quality of life. This study was aimed to objectively assess the impact of operative treatment of simple fistula-in-ano on quality of life related to anal incontinence. Therefore, a prospective study was conducted in 34 patients who underwent surgery for fistula-in-ano over a period of 24 months. Quality of life and incontinence were assessed using fecal incontinence quality of life (FIQL) scale and Cleveland clinic incontinence score (CCIS) preoperatively and after a minimum of 12 months follow up (mean-27 months, range 12-40 months)...
November 7, 2017: BMC Research Notes
Sameh Hany Emile, Hossam Elfeki, Mostafa Shalaby, Ahmad Sakr
BACKGROUND: Video-assisted anal fistula treatment (VAAFT) is a novel, minimally invasive technique for the treatment of fistula-in-ano (FIA). This review aimed to search the literature for the outcome of VAAFT regarding the recurrence and complication rates of the technique. METHODS: A systematic literature search was conducted in compliance with the PRISMA screening guidelines. PubMed/MEDLINE and Scopus were searched for articles reporting the outcomes of VAAFT procedure from inception through April 2017...
October 19, 2017: Surgical Endoscopy
George E Fowler, Christopher J Young
A seeded fistula-in-ano from a synchronous sigmoid colon cancer is rare. The literature is still divided regarding the standard treatment, although an abdominoperineal resection is considered the best option when curative resection is possible. This case is distinct from previous reports, as the patient had known metastatic liver disease before surgery, and proceeded with a pan-proctocolectomy after neo-adjuvant chemotherapy. The patient died 20 months post-operatively of his metastatic liver disease, having been otherwise asymptomatic for eight months on continued chemotherapy, before commencing palliative treatment (completed five cycles)...
July 23, 2017: Curēus
Sameh Hany Emile, Alaa Magdy, Mohamed Youssef, Waleed Thabet, Mahmoud Abdelnaby, Waleed Omar, Wael Khafagy
BACKGROUND: Tridimensional endoanal ultrasonography (3D-EAUS) has been used for the assessment of various anorectal lesions. Previous studies have reported good accuracy of 3D-EAUS in preoperative assessment of fistula-in-ano (FIA). This study aimed to assess the diagnostic utility of 3D-EAUS in preoperative evaluation of primary and recurrent FIA and its role in detection of associated anal sphincter (AS) defects. PATIENTS AND METHODS: Prospectively collected data of patients with FIA who were investigated with 3D-EAUS were reviewed...
November 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Songphol Malakorn, Tarik Sammour, Supakij Khomvilai, Irin Chowchankit, Shankar Gunarasa, Prapon Kanjanasilp, Charnjiroj Thiptanakij, Arun Rojanasakul
BACKGROUND: Ligation of intersphincteric fistula tract is a well-described sphincter-preserving technique for the management of fistula in ano. In 2007, we reported our early experience demonstrating a primary success rate of 94.4%. These findings have since been supported by several short-term studies, but long-term results and secondary cure rates after ligation of intersphincteric fistula tract failure remain unknown. OBJECTIVE: This study aims to report a 10-year experience of ligation of intersphincteric fistula tract with extended long-term follow-up...
October 2017: Diseases of the Colon and Rectum
Pankaj Garg, Pratiksha Singh
BACKGROUND: Video-Assisted Anal Fistula Treatment (VAAFT) is a relatively new minimally invasive videoendoscopic procedure for treating fistula-in-ano. We reviewed and performed metaanalysis to evaluate the efficacy of this procedure. METHODS: Studies from the period 2010 to 2016 were searched in PubMed, Medline, Scopus, Embase, Ovid, SCI database, Cochrane Central Register of Controlled Trials (CENTRAL) & Google Scholar database. All studies which utilized VAAFT to treat fistula-in-ano were extracted...
October 2017: International Journal of Surgery
Adil E Bharucha, Satish S C Rao, Andrea S Shin
The purpose of this clinical practice update expert review is to describe the key principles in the use of surgical interventions and device-aided therapy for managing fecal incontinence (FI) and defecatory disorders. The best practices outlined in this review are based on relevant publications, including systematic reviews and expert opinion (when applicable). Best Practice Advice 1: A stepwise approach should be followed for management of FI. Conservative therapies (diet, fluids, techniques to improve evacuation, a bowel training program, management of diarrhea and constipation with diet and medications if necessary) will benefit approximately 25% of patients and should be tried first...
December 2017: Clinical Gastroenterology and Hepatology
Anil Kumar, Manoj Kumar, Abhijeet Kumar Jha, Bindey Kumar, Rekha Kumari
Ksharsutra is a popular treatment modality in India for the management of fistula-in-ano. It works by the action of excision, scraping, draining, penetrating, debridement, and sclerosing as well as healing simultaneously without a surgical excision. The conventional method to insert a ksharsutra by using a metallic probe through an external opening may cause pain and discomfort to the patients. In some cases, this intervention is not possible without general anaesthesia. The ksharsutra may be inserted through an external opening by using an infant feeding tube (no...
August 2017: Indian Journal of Surgery
Leila Ghahramani, Mohammad Reza Minaie, Peyman Arasteh, Seyed Vahid Hosseini, Ahmad Izadpanah, Ali Mohammad Bananzadeh, Mahboobe Ahmadbeigi, Zahra Hooshanginejad
BACKGROUND: Much controversy exists regarding the role of antibiotics in the development of fistula in-ano after incision and drainage. We evaluated the role of postoperative antibiotics in the prevention of fistula in-ano after incision and drainage of perianal abscess. METHODS: In a randomized single blind clinical trial study, 307 patients were randomly selected from those referring for incision and drainage of perianal abscess at Shahid Faghihi Hospital, Shiraz, Iran, during September 2013 to September 2014...
November 2017: Surgery
F de la Portilla, J J Segura-Sampedro, M L Reyes-Díaz, M V Maestre, A M Cabrera, R M Jimenez-Rodríguez, J M Vázquez-Monchul, J M Diaz-Pavón, F J Padillo-Ruiz
PURPOSE: The aim of this paper is to evaluate to the safety, feasibility and efficacy of a novel treatment for transsphincteric cryptoglandular fistula: injection of autologous plasma rich in growth factors (PRGF) into the fistula tract accompanied by sealing using a fibrin plug created from the activated platelet-poor fraction of the same plasma. METHOD: This article is a prospective, phase II clinical trial. The procedure was externally audited. Thirty-six patients diagnosed with transsphincteric fistula-in-ano were included...
November 2017: International Journal of Colorectal Disease
U Jayarajah, D N Samarasekera
Introduction: Successful treatment of fistula-in-ano is sometimes challenging due to difficulty in recognising the internal opening and the course of the fistula tract. Although Goodsall’s rule was accepted in the past, as a method to determine the course of the fistula, recent data have shown conflicting results. Objectives: To study the predictive accuracy of Goodsall’s rule. Methods: A sample of 212 patients with simple fistulae were studied...
June 30, 2017: Ceylon Medical Journal
Charlotte Holbrook, Devesh Misra, Indre Zaparackaite, Stewart Cleeve
AIM: For decades, paediatric surgeons have employed the standard posterior sagittal anorectoplasty (PSARP) approach to deal with patients with anorectal malformations (ARM). In recent years, we noted an apparent increase in the incidence of anal stricture after surgical repair of ARM following the introduction of laparoscopic pull-through and techniques aiming to preserve the internal sphincter-the internal sphincter sparing approach (ISSA). We decided to analyse our data to find out if these new trends had added to the problem of post-operative strictures...
August 2017: Pediatric Surgery International
Sameh Hany Emile, Hossam Elfeki, Waleed Thabet, Ahmed Sakr, Alaa Magdy, Tito M Abd El-Hamed, Waleed Omar, Wael Khafagy
BACKGROUND: The optimal surgical treatment for high transsphincteric fistula-in-ano (FIA) should attain complete eradication of the fistulous track and, in the same time, not compromising the anal sphincters. The present study aimed to investigate the predictive factors for recurrence of high transsphincteric FIA after placement of draining seton and to evaluate the efficacy and complications of seton treatment for high cryptoglandular anal fistula. MATERIALS AND METHODS: This is a retrospective case-control study of patients with high transsphincteric FIA who were treated with seton placement...
June 1, 2017: Journal of Surgical Research
Aditya Nema, Sanjay Kumar Gupta, Tukaram S Dudhamal, Vyasadeva Mahanta
Ksharasutra (parasurgical procedure using a thread treated by alkalies) is being practiced in Indian system of medicine since ancient time for management of ano-rectal disorders; particularly for Bhagandara, (fistula in ano), and generally difficult to treat. In this case series, standard Ksharasutra was prepared as per the Ayurvedic Pharmacopeia of India and used to treat the different cases of Bhagandara. In this case series total 6 patients of Bhagandara were treated with Ksharasutra and partial fistulectomy...
April 2017: Journal of Ayurveda and Integrative Medicine
Andreas Nordholm-Carstensen, Peter-Martin Krarup, Kikke Hagen
BACKGROUND: The treatment of complex anocutaneous fistulas remains a major therapeutic challenge balancing the risk of incontinence against the chance of permanent closure. OBJECTIVE: The purpose of this study was to investigate the efficacy of a nitinol proctology clip for closure of complex anocutaneous fistulas. DESIGN: This is a single-center cohort study with retrospective analysis of all of the treated patients. SETTINGS: Data were obtained from patient records and MRI reports, as well as follow-up telephone calls and clinical follow-up with endoanal ultrasonography...
July 2017: Diseases of the Colon and Rectum
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