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high anal fistula

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https://www.readbyqxmd.com/read/28210857/permacol%C3%A2-collagen-paste-injection-for-the-treatment-of-complex-anal-fistula-1-year-follow-up
#1
B Fabiani, C Menconi, J Martellucci, I Giani, G Toniolo, G Naldini
BACKGROUND: Optimal surgical treatment for anal fistula should result in healing of the fistula track and preserve anal continence. The aim of this study was to evaluate Permacol™ collagen paste (Covidien plc, Gosport, Hampshire, UK) injection for the treatment of complex anal fistulas, reporting feasibility, safety, outcome and functional results. METHODS: Between May 2013 and December 2014, 21 consecutive patients underwent Permacol paste injection for complex anal fistula at our institutions...
February 16, 2017: Techniques in Coloproctology
https://www.readbyqxmd.com/read/28209416/efficacy-of-an-anal-fistula-plug-for-fistulas-in-ano-in-children
#2
Katsunori Kouchi, Ayao Takenouchi, Aki Matsuoka, Kiyoaki Yabe, Mashahiro Korai, Chikako Nakata
BACKGROUND: In children, perianal abscesses have a good prognosis and often heal with age. However, some perianal abscesses are refractory to treatment and remain as fistulas-in-ano. Treatment with a Surgisis Anal Fistula Plug® has been reported as a new method of treatment for fistulas. In adults, the plug has been reported to cause little pain and have a high cure rate, but there have been no reported cases of its use in children. PURPOSE: This study was designed to analyze the efficacy of the plug for closure of refractory fistulas in children...
February 2, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28151035/long-term-efficacy-and-safety-of-a-nitinol-closure-clip-system-for-anal-fistula-treatment
#3
Sebastian Dango, Fillimon Antonakis, Dirk Schrader, Arkadiy Radzikhovskiy, Michael B Ghadimi, Rudolf Hesterberg
INTRODUCTION: Treatment failure of anal fistula results in high re-occurrence rate. MATERIAL AND METHODS: Efficacy and safety of a nitinol closure clip system (bear-claw clip) were evaluated for anal fistulae treatment in a 36-month long-term follow-up study. RESULTS: Twenty-two patients were included. No patient had been treated with a bear-claw clip system before. All patients were fully continent before treatment. Follow-up time was 36 months (range 19-48 months)...
February 2, 2017: Minimally Invasive Therapy & Allied Technologies: MITAT
https://www.readbyqxmd.com/read/28133087/-a-case-of-carcinoma-associated-with-an-anal-fistula-repaired-using-a-hatchet-flap-after-neoadjuvant-chemoradiotherapy
#4
Masatoshi Kuroda, Eiji Ikeda, Nobuji Yokoyama, Masaichi Kenmotsu, Shoji Takagi, Toshihisa Yamano
The patient was a 53-year-old man who complained of perianal pain. He had a 20-year history of an anal fistula. There was a 10 cm tumor with mucin-like discharge on the left side of the anus. His CEA level was high, at 7.3 ng/mL, and T2-weighted MRI revealed a multilocular cystic tumor with high signal intensity. The second biopsy result indicated mucinous adenocarcinoma. We performed neoadjuvant chemoradiotherapy. The chemotherapy regimen was TS-1 with radiation therapy, along with 4-port irradiation(50.4 Gy)of the primary tumor, located at the interior of the pelvis and inguinal lymph nodes...
November 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28121970/resorbable-mesh-cranioplasty-repair-of-bilateral-cerebrospinal-fluid-leaks-following-pediatric-simultaneous-bilateral-auditory-brainstem-implant-surgery
#5
Giacomo Colletti, Marco Mandalà, Vittorio Colletti, Alberto Deganello, Fabiana Allevi, Liliana Colletti
OBJECTIVE: To present a child with cochlear nerve deficiency (CND) who received simultaneous bilateral simultaneous auditory brainstem implants (BS-ABI) and subsequently presented with bilateral cerebrospinal fluid (CSF) leaks unresponsive to standard treatments. To propose a novel rigid retrosigmoid cranioplasty for treating and preventing CSF leaks in children at high risk for this complication. PATIENT: A 3.5-year-old child with CND, vertebral defects, anal atresia, cardiac defects, tracheo-esophageal fistula, renal anomalies, and limb abnormalities, coloboma, heart defect, atresia choanae, retarded growth and development, genital abnormality, and ear abnormality, Arnold Chiari malformation, previous treated tracheo-esophageal fistula underwent BS-ABI...
January 24, 2017: Otology & Neurotology
https://www.readbyqxmd.com/read/28108825/photodynamic-therapy-for-the-treatment-of-complex-anal-fistula
#6
A Arroyo, P Moya, M A Rodríguez-Prieto, M J Alcaide, M M Aguilar, M Bellón, M T Pérez-Vázquez, F Candela, R Calpena
BACKGROUND: Photodynamic therapy (PDT) is a new procedure for the treatment of anal fistula. This preliminary study was designed to investigate the safety and effectiveness of this new technique in the treatment of anal fistula. METHODS: Ten patients were treated with PDT. Intralesional 5-aminolevulinic acid (ALA) 2% was directly injected into the fistula. The internal and external orifices were closed. After an incubation period of 2 h, the fistula was irradiated using an optical fibre connected to a red laser (MULTIDIODE 630 PDT, INTERmedic, Spain) operating at 1 W/cm for 3 min (180 Joules)...
January 20, 2017: Techniques in Coloproctology
https://www.readbyqxmd.com/read/28043558/comparison-of-histopathology-acid-fast-bacillus-smear-and-real-time-polymerase-chain-reaction-for-detection-of-mycobacterium-tuberculosis-in-anal-fistula-in-161-patients-a-prospective-controlled-trial
#7
Pankaj Garg, Mohinder K Garg, Narinder Agarwal
OBJECTIVE/BACKGROUND: Mycobacterium tuberculosis (MTB) is a known cause of refractory and recurrent fistula-in-ano. Histopathology of fistula tract and acid fast bacillus (AFB) smear of the pus are the standard procedures employed to diagnose MTB. However, they have some drawbacks. Nontubercular mycobacteria (NTM) has also been detected to cause fistula-in-ano and these methods cannot differentiate between MTB and NTM. Secondly, as these methods have low sensitivity, they could possibly be missing out MTB patients...
December 2016: International Journal of Mycobacteriology
https://www.readbyqxmd.com/read/28035458/modified-martius-flap-procedure-for-refractory-ileal-pouch-vestibular-fistula-a-report-of-three-cases
#8
Toshimitsu Araki, Yoshiki Okita, Mikio Kawamura, Satoru Kondo, Yuji Toiyama, Junichiro Hiro, Shigeyuki Yoshiyama, Keiichi Uchida, Masato Kusunoki
PURPOSE: Pouch-vaginal or vestibular fistula is an uncommon, but devastating complication that occurs in women after ileal J pouch-anal anastomosis. The management of these fistulae is challenging, and it is associated with high recurrence and pouch loss rates. This report describes the use of the modified Martius flap procedure for three patients with ulcerative colitis who developed refractory pouch-vestibular fistulae. RESULTS: Three patients with ulcerative colitis, who underwent total colectomy, mucosal proctectomy, and ileal pouch-anal anastomosis, developed pouch-vestibular fistulae...
December 29, 2016: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28000197/-efficacy-evaluation-of-laparoscopic-surgery-for-children-with-persistent-cloaca
#9
Chen Wang, Shuli Liu, Zhen Chen, Long Li, Wei Zheng
OBJECTIVE: To explore the feasibility and efficacy of laparoscopic surgery in the treatment of children with persistent cloaca. METHODS: Clinical data of 26 female children with high type persistent cloaca undergoing operation in the Capital Pediatric Institution between November 2005 and February 2015 were retrospectively analyzed. Mean age of these children was (1.4±1.6) years old. Distal end of rectum locating in the superior border of pubis was the standard of diagnosis...
December 25, 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28000196/-analysis-of-clinical-characteristics-of-perianal-crohn-s-disease-in-a-single-center
#10
Ping Zhu, Yugen Chen, Yunfei Gu, Hongjin Chen, Xiaohai An, Yingrui Cheng, Ying Gao, Bolin Yang
OBJECTIVE: To discuss the clinical features of perianal Crohn disease (PCD). METHODS: Clinical data of 52 PCD patients who were treated at the Department of Colorectal Surgery, Affiliated Hospital of Nanjing University of Chinese Medicine from June 2011 to October 2014 were analyzed retrospectively. Montreal classification, clinical symptoms, the subtype of perianal lesions, history of perianal surgery and medical treatment, disease active indexes, serum inflammation markers and nutritional indexes were included...
December 25, 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28000193/-clinical-characteristics-and-risk-factors-for-recurrence-of-anal-fistula-patients
#11
Jiaqin Li, Wei Yang, Zhijian Huang, Zubing Mei, Dacheng Yang, Haiyan Wu, Qingming Wang
OBJECTIVE: To investigate the epidemiology, internal opening location, and risk factors associated with recurrence of anal fistula. METHODS: Clinical data of 1783 hospitalized patients admitted for anal fistula treatment to Shanghai Shuguang Hospital from January 2013 to September 2015 were retrospectively analyzed. Fistula passing through anorectal ring or locating above was defined as high anal fistula (n=125). Internal opening location was defined as follows: posterior (5 to 7 o'clock), front(11 to 1 o'clock), left (2 to 4 o'clock) and right (8 to 10 o'clock)...
December 25, 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28000182/-current-situation-in-the-diagnosis-and-treatment-of-rectovaginal-fistula
#12
Hui Peng, Donglin Ren
The treatment of rectovaginal fistula is quite difficult. It is a formidable challenge for anorectal surgeons to successfully perform operations for rectovaginal fistulas, since both recurrence rate and incontinence rate are high. This commentary elucidates certain questions during the treatment course of rectovaginal fistula through reviewing relevant literature and our clinical practice, including the overall evaluation of the preoperative rectovaginal fistula, the choice of suitable operation timing, reasonable choice of operational procedure and standard perioperative management...
December 25, 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/27943527/three-dimensional-endoanal-ultrasound-is-accurate-and-reproducible-in-determining-type-and-height-of-anal-fistulae
#13
M Kołodziejczak, G A Santoro, A Obcowska, Z Lorenc, M Mańczak, I Sudoł-Szopińska
AIM: Surgical treatment of high anal fistulae is associated with potential risk of faecal incontinence and recurrence. The primary aim of this study was to determine the accuracy of three-dimensional endoanal ultrasound (3D-EAUS) in the assessment of height and type of anal fistulae, compared to the intraoperative findings (gold standard). The secondary aim was to evaluate the inter-observer reproducibility of 3D-EAUS. METHODS: The study design was a prospective analysis of retrospective data...
December 10, 2016: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/27878619/an-open-prospective-study-evaluating-efficacy-and-safety-of-a-new-medical-device-for-rectal-application-of-activated-carbon-in-the-treatment-of-chronic-uncomplicated-perianal-fistulas
#14
Antoni Zawadzki, Louis Banka Johnson, Måns Bohe, Claes Johansson, Mats Ekelund, Ole Haagen Nielsen
PURPOSE: It has been proposed that biological/chemical substances in the intestine might play a role in the occurrence and deterioration of perianal fistulas. Elimination of such unidentified factors from the lower gastrointestinal tract might offer a new strategy for the management of anal fistulas. The aim of this study was to evaluate the clinical effects on non-Crohn's disease perianal fistula healing, and the safety and tolerability of a new medical device that applies high-purity, high-activity granular activated carbon locally into the rectum twice daily of patients with perianal fistulas without any concomitant medication...
November 23, 2016: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/27855530/the-role-of-a-defunctioning-stoma-for-colonic-and-perianal-crohn-s-disease-in-the-biological-era
#15
M Martí-Gallostra, P Myrelid, N Mortensen, S Keshav, S P L Travis, B George
OBJECTIVE: A defunctioning stoma is a therapeutic option for colonic or perianal Crohn's disease. In the pre-biologic era the response rate to defunctioning in our unit was high (86%), but intestinal continuity was only restored in 11-20%. Few data exist on the outcome of defunctioning since the widespread introduction of biologicals. MATERIAL AND METHODS: All patients undergoing a defunctioning stoma for colonic/perianal Crohn's disease since 2003-2011 were identified from a prospective database...
March 2017: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/27847010/nontuberculous-mycobacteria-in-fistula-in-ano-a-new-finding-and-its-implications
#16
Pankaj Garg
OBJECTIVE/BACKGROUND: Nontuberculous mycobacteria (NTM) are not known to be associated with fistula-in-ano. NTM was detected in three fistula-in-ano patients in our series. In this study, related data was reviewed to find the mycobacterial disease in patients in our database. METHODS: In this study, 311 consecutive fistula-in-ano patients operated over 2years were analyzed. The histopathology of anal fistula tract epithelial lining of every operated patient was analyzed and other tests (real-time-polymerase chain reaction [RT-PCR], GeneXpert, and mycobacterial culture) were conducted in patients with high index of suspicion of having mycobacterial disease...
September 2016: International Journal of Mycobacteriology
https://www.readbyqxmd.com/read/27822874/spinal-epidural-abscess-a-rare-complication-of-ulcerative-colitis-after-ileal-pouch-anal-anastomosis
#17
Mikio Kawamura, Toshimitsu Araki, Yoshiki Okita, Satoru Kondo, Takashi Ichikawa, Hiroyuki Fujikawa, Keiichi Uchida, Yasuhiko Mohri, Masato Kusunoki
BACKGROUND: Spinal epidural abscess is a rare condition with high morbidity and mortality, for which a delay in diagnosis and treatment can lead to irreversible neurologic deficit or even death. Although patients with spinal epidural abscess have systemic predisposing immunocompromised conditions, spinal intervention, or trauma, this condition has been reported as a result of perforation or fistulization arising from inflammatory bowel disease. We describe herein a rare case of spinal epidural abscess as a complication of ileal pouch anal anastomosis...
December 2016: Surgical Case Reports
https://www.readbyqxmd.com/read/27704203/ileal-pouch-anal-anastomosis-for-ulcerative-colitis-a-canadian-institution-s-experience
#18
E Zittan, Grace W Ma, N Wong-Chong, R Milgrom, R S McLeod, M Silverberg, Z Cohen
BACKGROUND: We aimed to summarize the outcomes of ulcerative colitis (UC) patients receiving an ileal pouch-anal anastamosis (IPAA) over an 11-year period at a high-volume Canadian inflammatory bowel disease (IBD) center. METHODS: A retrospective chart review was performed for subjects with UC who underwent IPAA between 2002 and 2013. Patient charts were reviewed for demographic data, clinical characteristics, preoperative medical treatment, and surgical outcomes...
February 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/27695999/diversities-of-h-type-anorectal-malformation-a-systematic-review-on-a-rare-variant-of-the-krickenbeck-classification
#19
REVIEW
Shilpa Sharma, Devendra K Gupta
Congenital H-type fistula is a rare congenital rectourogenital connection with an external anal opening in a normal or ectopic position. A systematic review was done to study the anatomical types of congenital H-type fistula, embryology, clinical presentation, relative gender distribution, associated anomalies, investigative modalities, and recent advances in treatment of these lesions. A PubMed search included H-type anorectal malformation; H-type anorectal malformations; H-type anorectal; and H-type congenital anorectal that gave 9;43;76;26 abstracts, respectively...
October 1, 2016: Pediatric Surgery International
https://www.readbyqxmd.com/read/27682647/ileal-pouch-anal-anastomosis-20%C3%A2-years-later-is-it-still-a-good-surgical-option-for-patients-with-ulcerative-colitis
#20
Gentilini Lorenzo, Coscia Maurizio, Lombardi Pietro Maria, Marta Tanzanu, Laureti Silvio, Podda Mariangela, Poggioli Gilberto
PURPOSE: Short-term results after ileo-pouch anal anastomosis (IPAA) are well established; data are conflicting in long-standing patients. We retrospectively evaluated long-term complications and functional results after follow-up longer than 20 years. METHODS: Two hundred five patients with follow-up longer than 20 years have been identified out of 1112 IPAA performed in our institution; of these, 20 cases were lost at follow-up or decline to take part at the study...
December 2016: International Journal of Colorectal Disease
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