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high anal fistula

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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
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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...
October 4, 2016: 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
#13
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
#14
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
https://www.readbyqxmd.com/read/27680073/-applicability-and-indications-of-colonoscopic-screening-for-crohn-s-disease-in-patients-with-fistula-in-ano
#15
Xi Chen, Xiaosheng He, Yifeng Zou, Ping Lan
OBJECTIVE: To determine the indications of colonoscopic screening for Crohn's disease in patients with fistula-in-ano. METHODS: Clinical data of 302 patients with perianal fistula who received colonoscopy examination from January 2010 to December 2013 in the Department of Colorectal Surgery, The Sixth Affiliated Hospital, Sun Yat-sen University were analyzed retrospectively. Parameters for differentiating perianal Crohn's disease from nonspecific fistulae were screened by logistic regression analysis...
September 25, 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/27671704/direct-and-indirect-costs-for-anal-fistula-in-sweden
#16
Adam Lundqvist, Ida Ahlberg, Frida Hjalte, Mats Ekelund
INTRODUCTION: Anal fistula is an abnormal tract with an external and internal opening that cause leakage, discomfort, and occasionally pain. Surgery is standard treatment, but recurrence and anal incontinence is common. The objective of the study was to analyze resource use, costs and sick leave for newly diagnosed patients with anal fistula in Sweden. METHODS: The study was based on register data from linkages between Swedish population-based registers including patients treated for anal fistula in Västra Götaland County, Sweden...
September 24, 2016: International Journal of Surgery
https://www.readbyqxmd.com/read/27562822/internal-dressings-for-healing-perianal-abscess-cavities
#17
REVIEW
Stella R Smith, Katy Newton, Jennifer A Smith, Jo C Dumville, Zipporah Iheozor-Ejiofor, Lyndsay E Pearce, Paul J Barrow, Laura Hancock, James Hill
BACKGROUND: A perianal abscess is a collection of pus under the skin, around the anus. It usually occurs due to an infection of an anal gland. In the UK, the annual incidence is 40 per 100,000 of the adult population, and the standard treatment is admission to hospital for incision and drainage under general anaesthetic. Following drainage of the pus, an internal dressing (pack) is placed into the cavity to stop bleeding. Common practice is for community nursing teams to change the pack regularly until the cavity heals...
August 26, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27511212/risk-factors-for-morbidities-and-mortality-in-children-following-pneumonectomy
#18
Verónica Giubergia, Florencia Alessandrini, Carolina Barrias, Carlos Giuseppucci, Aixa Reusmann, Marcelo Barrenechea, Claudio Castaños
BACKGROUND AND OBJECTIVE: Pneumonectomy (PNE) is a procedure infrequently performed in children. A high morbidity/mortality rate associated with PNE has been described. Few series have been published in the last 15 years. Risk factors associated with morbidity/mortality after PNE were evaluated. Indications, course, survival and complications of PNE in children were also analized. METHODS: In a case series of 51 children who underwent PNE, death within 30 days of surgery, pneumonia, empyema, sepsis, adult respiratory distress syndrome, bronchopleural fistula, bleeding, pneumothorax and post-PNE syndrome were considered major morbidities...
January 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/27412123/characteristics-of-learning-curve-in-minimally-invasive-ileal-pouch-anal-anastomosis-in-a-single-institution
#19
Ahmet Rencuzogullari, Luca Stocchi, Meagan Costedio, Emre Gorgun, Hermann Kessler, Feza H Remzi
BACKGROUND: Previous work from our institution has characterized the learning curve for open ileal pouch-anal anastomosis (IPAA). The purpose of the present study was to assess the learning curve of minimally invasive IPAA. METHODS: Perioperative outcomes of 372 minimally invasive IPAA by 20 surgeons (10 high-volume vs. 10 low-volume surgeons) during 2002-2013, included in a prospectively maintained database, were assessed. Predicted outcome models were constructed using perioperative variables selected by stepwise logistic regression, using Akaike's information criterion...
July 12, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/27280009/treating-anal-fistula-with-the-anal-fistula-plug-case-series-report-of-12-patients
#20
Reza Bagherzadeh Saba, Adnan Tizmaghz, Somar Ajeka, Mehdi Karami
INTRODUCTION: Recurrent and complex high fistulas remain a surgical challenge. This paper reports our experience with the anal fistula plug in patients with complex fistulas. METHODS: Data were collected prospectively and analyzed from consecutive patients undergoing insertion of a fistula plug from January 2011 through April 2014 at Hazrat-e-Rasoul Hospital in Tehran. We ensured that sepsis had been eradicated in all patients prior to placement of the plug. During surgery, a conical shaped collagen plug was pulled through the fistula tract...
April 2016: Electronic Physician
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