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Fistula in ano

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https://www.readbyqxmd.com/read/28895031/utility-of-endoanal-ultrasonography-in-assessment-of-primary-and-recurrent-anal-fistulas-and-for-detection-of-associated-anal-sphincter-defects
#1
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...
September 11, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28891850/ligation-of-intersphincteric-fistula-tract-for-fistula-in-ano-lessons-learned-from-a-decade-of-experience
#2
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
https://www.readbyqxmd.com/read/28882770/video-assisted-anal-fistula-treatment-vaaft-in-cryptoglandular-fistula-in-ano-a-systematic-review-and-proportional-meta-analysis
#3
REVIEW
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...
September 4, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28838787/surgical-interventions-and-the-use-of-device-aided-therapy-for-the-treatment-of-fecal-incontinence-and-defecatory-disorders
#4
Adil E Bharucha, Satish S C Rao, Andrea Shin
DESCRIPTION: 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. METHODS: 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...
August 21, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28827918/the-easiest-way-to-insert-ksharsutra-with-the-help-of-an-infant-feeding-tube-instead-of-a-metallic-probe
#5
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
https://www.readbyqxmd.com/read/28822559/antibiotic-therapy-for-prevention-of-fistula-in-ano-after-incision-and-drainage-of-simple-perianal-abscess-a-randomized-single-blind-clinical-trial
#6
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...
August 16, 2017: Surgery
https://www.readbyqxmd.com/read/28755243/treatment-of-transsphincteric-fistula-in-ano-with-growth-factors-from-autologous-platelets-results-of-a-phase-ii-clinical-trial
#7
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...
July 29, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28697591/predictive-accuracy-of-goodsall%C3%A2-s-rule-for-fistula-in-ano
#8
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
https://www.readbyqxmd.com/read/28616723/post-operative-strictures-in-anorectal-malformation-trends-over-15%C3%A2-years
#9
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
https://www.readbyqxmd.com/read/28601324/predictive-factors-for-recurrence-of-high-transsphincteric-anal-fistula-after-placement-of-seton
#10
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
https://www.readbyqxmd.com/read/28600166/transrectal-ultra-sonography-based-evidence-of-ksharasutra-therapy-for-fistula-in-ano-a-case-series
#11
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
https://www.readbyqxmd.com/read/28594722/treatment-of-complex-fistula-in-ano-with-a-nitinol-proctology-clip
#12
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
https://www.readbyqxmd.com/read/28414118/comparing-existing-classifications-of-fistula-in-ano-in-440-operated-patients-is-it-time-for-a-new-classification-a-retrospective-cohort-study
#13
Pankaj Garg
BACKGROUND: Fistula-in-ano are classified so as to grade them according to increasing complexity which can help guide their management. The classifications used are Parks, St James Hospital University (SJHU) and Standard Practice Task Force (SPTF). Laying open (fistulotomy) of the fistula tract is the most commonly done procedure for fistula-in-ano and has high success rate. The lower grade fistulas are supposed to have low risk of incontinence when laid open and vice-versa. The objective of the study was to evaluate the efficacy of the existing classifications...
June 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28387062/association-of-coloproctology-of-great-britain-and-ireland-consensus-exercise-on-surgical-management-of-fistulating-perianal-crohn-s-disease
#14
M J Lee, N Heywood, P M Sagar, S R Brown, N S Fearnhead
AIM: Management of fistulating perianal Crohn's disease (fpCD) is a significant challenge for a colorectal surgeon. A recent survey of surgical practice in this condition showed variation in management approaches. As a result we set out to devise recommendations for practice for UK colorectal surgeons. METHOD: Results from a national survey were used to devise a set of potential consensus statements. Consultant colorectal surgeons were invited to participate in the exercise via the previous survey and the mailing list of the professional society...
May 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28348488/experimental-porcine-model-of-complex-fistula-in-ano
#15
COMPARATIVE STUDY
Ma-Mu-Ti-Jiang A Ba-Bai-Ke-Re, Hui Chen, Xue Liu, Yun-Hai Wang
AIM: To establish and evaluate an experimental porcine model of fistula-in-ano. METHODS: Twelve healthy pigs were randomly divided into two groups. Under general anesthesia, the experimental group underwent rubber band ligation surgery, and the control group underwent an artificial damage technique. Clinical magnetic resonance imaging (MRI) and histopathological evaluation were performed on the 38(th) d and 48(th) d after surgery in both groups, respectively. RESULTS: There were no significant differences between the experimental group and the control group in general characteristics such as body weight, gender, and the number of fistula (P > 0...
March 14, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28303978/fistulotomy-versus-fistulectomy-for-simple-fistula-in-ano-a-retrospective-cohort-study
#16
Ghulam Murtaza, Fareed Ahmed Shaikh, Tabish Chawla, Batool Urooj Rajput, Noman Shahzad, Sumaiya Ansari
OBJECTIVE: To compare fistulotomy with fistulectomy for wound healing, duration of surgery, post-operative pain, incontinence and recurrence in patients with fistula in ano. METHODS: This retrospective cohort study was conducted at the Aga Khan University Hospital, Karachi, and comprised data of adults who had undergone fistulotomy/fistulectomy for simple fistula in ano from January 2007 to August 2012. Data collection was done in August 2013 using questionnaire and telephonic interviews...
March 2017: JPMA. the Journal of the Pakistan Medical Association
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
#17
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...
April 2017: Techniques in Coloproctology
https://www.readbyqxmd.com/read/28259693/transanal-opening-of-intersphincteric-space-tropis-a-new-procedure-to-treat-high-complex-anal-fistula
#18
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...
April 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28247060/rectal-advancement-flap-for-the-treatment-of-complex-cryptoglandular-anal-fistulas-a-systematic-review-and-meta-analysis
#19
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...
May 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28228247/the-changes-in-resting-anal-pressure-after-performing-full-thickness-rectal-advancement-flaps
#20
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...
September 2017: American Journal of Surgery
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