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Fistulotomy

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https://www.readbyqxmd.com/read/29730907/is-the-isolated-tip-needle-knife-precut-as-effective-as-conventional-precut-fistulotomy-in-difficult-biliary-cannulation
#1
Tae Hoon Lee, Sang Heum Park, Jae Kook Yang, Su Jung Han, Suyeon Park, Hyun Jong Choi, Yun Nah Lee, Sang-Woo Cha, Jong Ho Moon, Young Deok Cho
Background/Aims: Needle-knife precut fistulotomy (NK-F) is a well-known freehand technique for difficult biliary cannulation (DBC). Another approach involves the Iso-Tome® , a modified precutting device with an insulated needle tip to prevent direct thermal injury. This comparative study aimed to evaluate the efficacy of the Iso-Tome® precut (IT-P) compared to that of NK-F for DBC. Methods: Patients with a naïve papilla who underwent early IT-P or NK-F for DBC were enrolled...
May 4, 2018: Gut and Liver
https://www.readbyqxmd.com/read/29713133/papillary-fistulotomy-vs-conventional-cannulation-for-endoscopic-biliary-access-a-prospective-randomized-trial
#2
Carlos Kiyoshi Furuya, Paulo Sakai, Fabio Ramalho Tavares Marinho, Jose Pinhata Otoch, Spencer Cheng, Lívia Lemes Prudencio, Eduardo Guimarães Hourneaux de Moura, Everson Luiz de Almeida Artifon
AIM: To compare the cannulation success, biochemical profile, and complications of the papillary fistulotomy technique vs catheter and guidewire standard access. METHODS: From July 2010 to May 2017, patients were prospectively randomized into two groups: Cannulation with a catheter and guidewire (Group I) and papillary fistulotomy (Group II). Amylase, lipase and C-reactive protein at T0, as well as 12 h and 24 h after endoscopic retrograde cholangiopancreatography, and complications (pancreatitis, bleeding, perforation) were recorded...
April 28, 2018: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/29666721/needle-knife-fistulotomy-for-the-rescue-an-unusual-cause-of-iatrogenic-extrahepatic-biliary-obstruction
#3
Laura L Ulmer, Lokesh K Jha, Neil Bhogal, Saurabh Kapur, Saurabh Chandan, Derrick Eichele, Ishfaq Bhat, Shailender Singh
A 71-year-old male presented to our institution with cholestatic hepatitis after having recently undergone upper endoscopy for treatment of gastrointestinal bleeding. Further investigation with endoscopic retrograde cholangiopancreatography revealed a hemostatic clip on the ampulla of Vater. After initial attempts at cannulation of the common bile duct were unsuccessful, biliary decompression was achieved by use of needle-knife fistulotomy. A common bile duct stent was placed and the liver function tests improved prior to discharge...
2018: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/29618340/3d-high-resolution-anorectal-manometry-in-patients-with-perianal-fistulas-comparison-with-3d-anal-ultrasound
#4
Richelle J F Felt-Bersma, Maarten S Vlietstra, Paul F Vollebregt, Ingrid J M Han-Geurts, Vera Rempe-Sorm, Grietje J H Vander Mijnsbrugge, Charlotte B H Molenaar
BACKGROUND: Perianal fistula surgery can damage the anal sphincters which may cause faecal incontinence. By measuring regional pressures, 3D-HRAM potentially provides better guidance for surgical strategy in patients with perianal fistulas. The aim was to measure regional anal pressures with 3D-HRAM and to compare these with 3D-EUS findings in patients with perianal fistulas. METHODS: Consecutive patients with active perianal fistulas who underwent both 3D-EUS and 3D-HRAM at a clinic specialised in proctology were included...
April 4, 2018: BMC Gastroenterology
https://www.readbyqxmd.com/read/29593864/laparoscopic-abdominoperineal-resection-for-the-treatment-of-a-mucinous-adenocarcinoma-associated-with-an-anal-fistula
#5
Dimosthenis Chrysikos, Theodoros Mariolis-Sapsakos, Tania Triantafyllou, Vasileios Karampelias, Apostolos Mitrousias, George Theodoropoulos
Mucinous adenocarcinoma associated with an anal fistula is a rare oncologic entity which may pose diagnostic and therapeutic challenges for Surgeons and Medical Oncologists. Few reported cases without definite therapeutic guidelines exist. It represents 2-3% of all gastrointestinal malignancies and arises from chronic anal fistulas, ischiorectal or perianal abscesses. We report a case of perianal mucinous adenocarcinoma in a 65-year-old male initially surgically treated multiple times for a recurrent fistula in ano of 5 years duration...
March 2018: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/29566478/the-usefulness-of-cap-assisted-endoscopic-retrograde-cholangiopancreatography-for-cannulation-complicated-by-a-periampullary-diverticulum
#6
Joonhwan Kim, Jun Soo Lee, Eui Joo Kim, Yeon Suk Kim, Jae Hee Cho
Endoscopic retrograde cholangiopancreatography (ERCP) is an advanced therapeutic procedure to manage choledocholithiasis and pancreatobiliary malignancy. On occasion, ERCP failure is encountered due to difficulties in cannulation. We assessed the safety and feasibility of cap-assisted ERCP via analyzing cases in which cannulation was complicated by periampullary diverticulum. Between November 2013 and March 2014, ERCP procedures were performed in 346 patients in our tertiary medical center. Among the 73 patients who had a periampullary diverticulum, conventional ERCP failed in 5 patients due to hidden papilla (n=3) or use of tangential approach (n=2)...
March 25, 2018: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
https://www.readbyqxmd.com/read/29518817/precut-fistulotomy-widening-its-limits
#7
João Fernandes, Diogo Libânio, Sílvia Giestas, José Ramada, David Martinez-Ares, Jorge Canena, Luís Lopes
No abstract text is available yet for this article.
March 8, 2018: Endoscopy
https://www.readbyqxmd.com/read/29501418/endoscopic-fistulotomy-in-inflammatory-bowel-disease-with-video
#8
Gursimran Kochhar, Bo Shen
BACKGROUND AND AIMS: Fistulas in patients with inflammatory bowel disease (IBD) poses a key challenge in the management of the IBD patients. We aimed to describe a novel endoscopic method to treat the IBD patients who have fistulas. METHODS: A cohort of 29 consecutive patients with a fistula and IBD were identified in the registry of our interventional IBD unit. The endoscopic fistulotomy with needle-knife was performed. The primary outcome was healing of the fistula without the need for surgical intervention...
February 28, 2018: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/29228753/the-best-surgical-strategy-for-anal-fistula-based-on-a-network-meta-analysis
#9
Qi Wang, Yukun He, Jun Shen
Objective: To determine a superior surgical treatment for anal fistula through a network meta-analysis and to provide the best direction for development in this field. Methods: We conducted a systematic literature search of the PubMed, Embase and Cochrane Library databases and extracted data from randomized controlled trials, which compared healing time, incontinence and recurrence associated with surgical strategies for anal fistula. A network meta-analysis was conducted using ADDIS software by evaluating the 3 parameters...
November 17, 2017: Oncotarget
https://www.readbyqxmd.com/read/29205737/combined-treatment-approach-to-chronic-anal-fissure-with-associated-anal-fistula
#10
Andrew J FitzDowse, Corina C Behrenbruch, Ian P Hayes
BACKGROUND: Anal fistula in association with chronic anal fissure (fissure-fistula) is infrequently described. Recognizing this association and managing both components may help prevent some treatment failures seen with chronic anal fissure. This study aims to report on the outcomes of 20 consecutive patients with fissure-fistula managed with fistulotomy and injection of botulinum A toxin. METHODS: The study is a retrospective, observational study, assessing the success of symptom resolution following fistulotomy with botulinum A toxin, in patients identified as having a chronic anal fissure with associated anal fistula...
December 3, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/29146001/what-happens-after-a-failed-lift-for-anal-fistula
#11
Moriah Wright, Alan Thorson, Garnet Blatchford, Maniamparampil Shashidharan, Jennifer Beaty, Noelle Bertelson, Piyush Aggrawal, Lindsay Taylor, Charles A Ternent
BACKGROUND: Ligation of the intersphincteric fistula tract (LIFT) was developed to treat transsphincteric anal fistulas. The aftermath of a failed LIFT has not been well documented. METHODS: Retrospective chart review of LIFT procedure for transsphincteric anal fistula between March 2012 and September 2016. RESULTS: 53 patients with LIFT procedure were identified, 20 (37.7%) had persistent fistula with median followup of 4 months. Following LIFT, recurrence of fistula was transsphincteric (75%) or intersphincteric (25%) (p = NS)...
December 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/29080959/short-term-efficacy-and-safety-of-three-novel-sphincter-sparing-techniques-for-anal-fistulae-a-systematic-review
#12
REVIEW
S O Adegbola, K Sahnan, G Pellino, P J Tozer, A Hart, R K S Phillips, J Warusavitarne, O D Faiz
BACKGROUND: The surgical treatment of complex anal fistulae, particularly those involving a significant portion of the anal sphincter in which fistulotomy would compromise continence, is challenging. Video-assisted anal fistula treatment (VAAFT), fistula tract laser closure (FiLaC™) and over-the-scope clip (OTSC® ) proctology system are all novel sphincter-sparing techniques targeted at healing anal fistulae. In this study, all published articles on these techniques were reviewed to determine efficacy, feasibility and safety...
October 2017: Techniques in Coloproctology
https://www.readbyqxmd.com/read/28891850/ligation-of-intersphincteric-fistula-tract-for-fistula-in-ano-lessons-learned-from-a-decade-of-experience
#13
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/28669408/patterns-of-recurrence-persistence-of-criptoglandular-anal-fistula-after-the-lift-procedure-long-term-observacional-study
#14
Carlos Placer Galán, Claudia Lopes, José Andrés Múgica, Yolanda Saralegui, Nerea Borda, José M Enriquez Navascues
OBJECTIVE: To study the recurrence/persistence rate of complex cripotoglandular anal fistula after the LIFT procedure and analyse the patterns of recurrence/persistence. PATIENTS AND METHODS: Observational study of patients with transe-sphincteric or supra-sphincteric anal fistula treated using the LIFT procedure from December 2008 to April 2016. Variables studied included clinical characteristics, surgical technique and results. Clinical cure was defined and imaging studies were used in doubtful cases...
August 2017: Cirugía Española
https://www.readbyqxmd.com/read/28462237/endoscopic-fistulotomy-heals-a-y-shaped-entero-entero-cutaneous-fistula
#15
Helen Lee, Bo Shen
Patients may develop fistulas due to Crohn's disease or as a postoperative complication after restorative proctocolectomy with ileal pouch anal anastomosis. Unfortunately, the treatment of fistulas can be challenging. The current standard of care may include medical therapy and/or surgical intervention. However, endoscopic treatment for postoperative pouch complications has emerged as a valid alternative option. We describe a case of persistent drainage from a Y-shaped entero-entero-cutaneous fistula that resolved after endoscopic fistulotomy with needle knife...
2017: ACG Case Reports Journal
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
#16
COMPARATIVE STUDY
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/28303978/fistulotomy-versus-fistulectomy-for-simple-fistula-in-ano-a-retrospective-cohort-study
#17
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
#18
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/28251361/german-s3-guidelines-anal-abscess-and-fistula-second-revised-version
#19
REVIEW
Andreas Ommer, Alexander Herold, Eugen Berg, Alois Fürst, Stefan Post, Reinhard Ruppert, Thomas Schiedeck, Oliver Schwandner, Bernhard Strittmatter
BACKGROUND: The incidence of anal abscess and fistula is relatively high, and the condition is most common in young men. METHODS: This is a revised version of the German S3 guidelines first published in 2011. It is based on a systematic review of pertinent literature. RESULTS: Cryptoglandular abscesses and fistulas usually originate in the proctodeal glands of the intersphincteric space. Classification depends on their relation to the anal sphincter...
March 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/28153572/exploring-endoscopic-therapy-for-the-treatment-of-crohn-s%C3%A2-disease-related-fistula-and-abscess
#20
REVIEW
Bo Shen
Fistula and abscess represent penetrating disease phenotypes of Crohn's disease (CD) and can develop in patients with or without prior history of CD-related surgery. While CD fistula and abscess have been traditionally treated with medical and surgical therapy, the role of endoscopic therapy in this particular phenotype of CD is expanding recently, thanks to advanced endoscopic techniques and a better understanding of pathogenesis and natural history of the disease and principle of treatment. The success of endoscopic treatment for inflammatory bowel disease depends on comprehension and appreciation of principles, then techniques, followed by instrument and device...
June 2017: Gastrointestinal Endoscopy
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