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H A Owen, G N Buchanan, A Schizas, A Emmanuel, R Cohen, A B Williams
INTRODUCTION: Anal fistula causes pain, discharge of pus and blood. Fistulotomy has the highest success, however, can risk continence; treatment balances cure with continence. This study assessed the impact of fistulotomy on Quality Of Life (QOL) and continence. METHODS: Patients selected for fistulotomy prospectively completed St Mark's Continence Score (full incontinence = 24) and Short Form - 36 questionnaires pre-operatively at two institutions with an interest in anal fistula, and reassessed 3 months post-operatively...
October 5, 2016: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
S H Emile, H Elfeki, M Abdelnaby
BACKGROUND: Fistula-in-ano (FIA) in infants differs, in several ways, from FIA in adults. The current review aims to assess FIA in infants less than 2 years old and to illustrate the outcome of different treatment modalities described in the literature. METHODS: An organized search of the English literature over the past 25 years was conducted according to the preferred reporting items for systematic reviews and meta-analyses guidelines. Electronic databases and Google Scholar were searched for articles focusing on management of FIA in infants...
September 23, 2016: Techniques in Coloproctology
Tae Hoon Lee, Sang-Heum Park
Various endoscopic techniques have been developed to overcome the difficulties in biliary or pancreatic access during endoscopic retrograde cholangiopancreatography, according to the preference of the endoscopist or the aim of the procedures. In terms of endoscopic methods, guidewire-assisted cannulation is a commonly used and well-known initial cannulation technique, or an alternative in cases of difficult cannulation. In addition, precut sphincterotomy encompasses a range of available rescue techniques, including conventional precut, precut fistulotomy, transpancreatic septotomy, and precut after insertion of pancreatic stent or pancreatic duct guidewire-guided septal precut...
September 2016: Clinical Endoscopy
I Papaconstantinou, E Kontis, V Koutoulidis, G Mantzaris, I Vassiliou
BACKGROUND AND AIM: Fistula-in-ano is a common problem among patients with Crohn's disease and carries significant morbidity. We aimed to study the outcomes of surgical treatment of fistula-in-ano after fistulotomy or seton placement in patients with perianal fistulizing Crohn's disease. MATERIAL AND METHODS: A retrospective observational study of 59 patients diagnosed with Crohn's disease, who were treated surgically for fistula-in-ano between 2010 and 2014 in our department...
August 22, 2016: Scandinavian Journal of Surgery: SJS
M J Lee, N Heywood, P M Sagar, S R Brown, N S Fearnhead
AIM: Around one-third of patients with Crohn's disease are affected by Crohn's fistula-in-ano (pCD). It typically follows a chronic course and patients undergo long-term medical and surgical therapy. We set out to describe current surgical practice in the management of pCD in the UK. METHODS: A survey of surgical management of pCD was designed by an expert group of colorectal surgeons and gastroenterologists. This assessed acute, elective, multidisciplinary and definitive surgical management...
July 16, 2016: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
Pier Alberto Testoni, Alberto Mariani, Lars Aabakken, Marianna Arvanitakis, Erwan Bories, Guido Costamagna, Jacques Devière, Mario Dinis-Ribeiro, Jean-Marc Dumonceau, Marc Giovannini, Tibor Gyokeres, Michael Hafner, Jorma Halttunen, Cesare Hassan, Luis Lopes, Ioannis S Papanikolaou, Tony C Tham, Andrea Tringali, Jeanin van Hooft, Earl J Williams
This Guideline is an official statement of the European Society of Gastrointestinal Endoscopy (ESGE). It provides practical advice on how to achieve successful cannulation and sphincterotomy at minimum risk to the patient. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system was adopted to define the strength of recommendations and the quality of evidence. Main recommendations 1 ESGE suggests that difficult biliary cannulation is defined by the presence of one or more of the following: more than 5 contacts with the papilla whilst attempting to cannulate; more than 5 minutes spent attempting to cannulate following visualization of the papilla; more than one unintended pancreatic duct cannulation or opacification (low quality evidence, weak recommendation)...
July 2016: Endoscopy
Qi-Sheng Zhang, Bing Han, Jian-Hua Xu, Peng Gao, Yu-Cui Shen
BACKGROUND AND AIMS: Needle-knife papillotomy and fistulotomy (NKPF) is a new, modified technique designed for difficult biliary cannulation. The safety and efficacy of performing NKPF based on characteristics of main duodenal papilla (MDP) was evaluated. METHODS: We performed a retrospective review of consecutive patients with intact papilla who were established as candidates for therapeutic ERCP at tertiary referral center. A total of 532 patients were included in conventional endoscopic retrograde cholangiopancreatography (ERCP) group in which repeated cannulation was tried in patients with difficult bile duct cannulation; and 598 patients enrolled in early NKPF group according to predefined parameters...
April 29, 2016: Surgical Endoscopy
Young-Joo Jin, Seok Jeong, Don Haeng Lee
BACKGROUND: /Aim: We intended to assess the feasibility of needle-knife fistulotomy (NKF) as an initial procedure for biliary access in common bile duct (CBD) stone patients who were at increased risk for post-ERCP pancreatitis (PEP). METHOD: Fifty-five patients who underwent ERCP with NKF for CBD stone at our institution between July, 2013, and May, 2015, were prospectively enrolled in this study. They had one or more of the following risk factors for PEP: young age (<60 years), female, or normal CBD diameter (≤9 mm)...
April 18, 2016: Gastrointestinal Endoscopy
Luís Lopes, Mário Dinis-Ribeiro, Carla Rolanda
BACKGROUND: While there are guidelines for appropriate training in ERCP, these are non-existent for needle-knife precut. The aim of this study was: (1) evaluate the experience curve of three endoscopists in needle-knife fistulotomy (NKF); (2) propose a minimum number of NKF procedures to attest proficiency. METHODS: Between November 1997 and March 2011, the first 120 consecutive NKF performed by three endoscopists (A, B, and C) were selected (360 patients) from three centers...
April 2016: Endoscopy International Open
Domenico Albano, Giovanni Bosio, Barbara Paghera, Francesco Bertagna
Diagnosing prosthetic joint infection is difficult; clinical signs and symptoms, laboratory tests, radiography, and joint aspiration are less sensitive and specific. We report a patient with fever and painful bilateral hip prosthesis, who underwent Tc-sulesomab scan showing moderate tracer uptake at the lateral surface of the right thigh and no signs of prosthesis infection. The F-FDG-PET/CT showed high uptake at the soft tissue of the right hip prosthesis and detected a fistula. Moreover PET/CT discovered an initial bone marrow involvement at the right femur...
June 2016: Clinical Nuclear Medicine
Chen Wang, Lester Rosen
This study evaluates low transsphincteric anal fistula managed by serial setons and interval fistulotomy, with attention to healing without recurrence and preservation of continence. Following Institutional Review Board approval, consecutive anal fistula operations performed by a single surgeon from January 1, 2009 to December 31, 2013 were retrospectively reviewed using electronic medical records and telephone interviews for patients lost to follow up. Of the 71 patients, 26 (37%) had low transsphincteric fistula (23 males and 3 females; mean age: 46 years), treated at our institution by seton placement followed by interval surgical muscle cutting and subsequent seton replacement or final fistulotomy...
March 2016: Journal of Integrative Medicine
Łukasz Dziki, Michał Mik, Radzisław Trzciński, Marcin Włodarczyk, Mariusz Skoneczny, Adam Dziki
UNLABELLED: A perianal fistula is a pathological canal covered by granulation tissue connecting the anal canal and perianal area epidermis. The above-mentioned problem is the reason for the patient to visit the surgeonproctologist. Unfortunately, the disease is characterized by a high recurrence rate, even despite proper management. The aim of the study was to determine the current condition of perianal fistula treatment methods in everyday surgical practice, considering members of the Society of Polish Surgeons...
December 2015: Polski Przeglad Chirurgiczny
Alexander Juth Karlsson, Martin Salö, Pernilla Stenström
INTRODUCTION: In children treated surgically for first-time perianal abscesses, discovery and excision of concomitant fistulas may also be warranted. AIM: To evaluate children of varying age after incision and drainage of first-time perianal abscesses, examining recurrences rates with and without search for a fistula. METHOD: A retrospective review was conducted, analyzing children (ages 0-15 years) treated for first-time perianal abscesses at a tertiary pediatric surgical center, with a minimum follow-up of 6 months...
2016: BioMed Research International
Hironari Kato, Koichiro Tsutsumi, Hiroyuki Okada
No abstract text is available yet for this article.
April 2016: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
A P Visscher, D Schuur, R A E Slooff, W J H J Meijerink, C B H Deen-Molenaar, R J F Felt-Bersma
AIM: Precise information regarding the location of an anal fistula and its relationship to adjacent structures is necessary for selecting the best surgical strategy. Retrospective and cross-sectional studies were performed to determine predictive factors for recurrence of anal fistula from preoperative examination by three-dimensional endoanal ultrasound (3D-EAUS). METHOD: Patients in our tertiary centre and in a private centre specialized in proctology undergoing preoperative 3D-EAUS for cryptoglandular anal fistulae between 2002 and 2012 were included...
May 2016: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
Jacek Hermann, Piotr Eder, Tomasz Banasiewicz, Konrad Matysiak, Liliana Łykowska-Szuber
Anal fistulas occurring in Crohn's disease (CD) comprise a risk factor of severe course of inflammation. They are frequently intractable due to various factors such as penetration of the anal canal or rectal wall, impaired wound healing, and immunosuppression, among others. Anal fistulas typical to CD develop from fissures or ulcers of the anal canal or rectum. Accurate identification of the type of fistula, such as low and simple or high and complex, is crucial for prognosis as well as for the choice of treatment...
2015: Przegla̜d Gastroenterologiczny
L Abramowitz, D Soudan, M Souffran, D Bouchard, A Castinel, J M Suduca, G Staumont, F Devulder, F Pigot, R Ganansia, M Varastet
AIM: The study aimed to evaluate outcome at 1 year of one- and two-stage fistulotomy for anal fistula in a large group of patients. METHOD: A prospective multicentre observational study was designed to include patients with anal fistula treated by one- or two-stage fistulotomy. Data were collected using a self-administered questionnaire before surgery, during healing and at 1 year after surgery. RESULTS: Group A (133 patients) with a low anal fistula underwent a one-stage fistulotomy...
March 2016: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
V D Pai, S Jatal, R Engineer, V Ostwal, A P Saklani
AIM: Adenocarcinomas associated with anal fistula are rare and often present at an advanced stage. They are often mistaken for commonly occurring benign diseases, leading to delayed diagnosis. Previous reports have predicted inferior oncological outcomes for these cases compared with sporadic rectal cancers. We are presenting our series of patients with colorectal adenocarcinoma associated with anal fistula who were treated with multimodality therapy at a tertiary cancer centre in India...
November 2015: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
Gouranga Dutta, Jayanta Bain, Ajay Kumar Ray, Soumedhik Dey, Nandini Das, Biswanath Das
BACKGROUND: Most commonly practiced surgical "lay open" technique to treat fistula-in-ano (a common anorectal pathology) has high rate of recurrence and anal incontinence. Alternatively, a nonsurgical cost efficient treatment with Ksharasutra (cotton Seton coated with Ayurvedic medicines) has minimal complications. In our study, we have tried to compare these two techniques. MATERIALS AND METHODS: A prospective randomized control study was designed involving patients referred to the Department of General Surgery in RG Kar Medical College, Kolkata, India, from January 2010 to September 2011...
July 2015: Journal of Natural Science, Biology, and Medicine
Sławomir Kozieł, Piotr Papaj, Katarzyna Dobija-Kubica, Przemysław Śleziński, Józef Wróbel
Cholelithiasis is diagnosed in 10% of the population of the USA and Western Europe. A rare but serious complication of cholelithiasis is the obstruction of the digestive tract caused by a gall-stone (Bernard syndrome). It can add up to 1-4% of the mechanical obstructions of a small intestine among the general population but it can result in nonstriangulational mechanical obstructions of a small intestine in 25% cases among the patients over the age of 65. 5 patients have undergone an operation due to a small intestine gall-stone ileus in years 2011-2013 (within 27 months) in the General Surgery Ward of the Beskid Oncology Center - Municipal Hospital...
May 2015: Polski Przeglad Chirurgiczny
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