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Fistulotomy

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https://www.readbyqxmd.com/read/28891850/ligation-of-intersphincteric-fistula-tract-for-fistula-in-ano-lessons-learned-from-a-decade-of-experience
#1
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
#2
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...
June 29, 2017: Cirugía Española
https://www.readbyqxmd.com/read/28462237/endoscopic-fistulotomy-heals-a-y-shaped-entero-entero-cutaneous-fistula
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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...
January 31, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/27785311/obesity-and-outcome-of-crohn-s-associated-perianal-fistula-surgery-a-case-control-study
#9
Ashish Manne, Ali S Khan, Talha A Malik
BACKGROUND: Evidence suggests that obesity (body mass index (BMI) > 30 kg/m(2)) adversely affects several outcomes in Crohn's disease (CD). CD-associated perianal fistula (CDPF) represents a debilitating phenotype with a clinical course that may be affected by obesity. We hypothesized that obese CD patients would be more likely to have poor outcomes following CDPF surgery. METHODS: We designed a case-control study of CD patients who underwent surgery for CDPF between 2000 and 2013 with documented pre-operative BMI and post-operative outcome...
December 2015: Gastroenterology Research
https://www.readbyqxmd.com/read/27777858/meta-analysis-of-randomized-clinical-trials-comparing-fistulectomy-versus-fistulotomy-for-low-anal-fistula
#10
Yansong Xu, Siyuang Liang, Weizhong Tang
OBJECTIVE: We evaluated the efficacy of fistulectomy compared to fistulotomy, and which procedure was the best procedure for patients with low anal fistula. METHODS: The literature search included PubMed, EMBASE, Cochrane library, Google original studies and a manual search of reference on the topic of fistulectomy compared to fistulotomy for anal fistula that had a deadline for publication by June 2016. Randomized controlled trials studies were included in the review...
2016: SpringerPlus
https://www.readbyqxmd.com/read/27765686/ef%C3%AF-cacy-of-10-sucralfate-ointment-after-anal-fistulotomy-a-prospective-double-blind-randomized-placebo-controlled-trial
#11
RANDOMIZED CONTROLLED TRIAL
Mina Alvandipour, Shahram Ala, Hasan Tavakoli, Jamshid Yazdani Charati, Afshin Shiva
INTRODUCTION: The most frequent problems after anal fistulotomy are pain, bleeding, and delayed or impaired wound healing. Topical Sucralfate preparation has been used to treat a wide variety of wounds. In this study, we investigate effects of 10% sucralfate ointment on wound healing and postoperative pain after fistulotomy. METHODS AND MATERIALS: A total of 41 patients undergoing anorectal fistulotomy were included in this randomized, blinded, controlled trial and were randomly allocated to either sucralfate ointment (every 12 h) or placebo...
December 2016: International Journal of Surgery
https://www.readbyqxmd.com/read/27704667/quality-of-life-following-fistulotomy-short-term-follow-up
#12
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
https://www.readbyqxmd.com/read/27663698/a-systematic-review-of-the-management-of-anal-fistula-in-infants
#13
REVIEW
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...
November 2016: Techniques in Coloproctology
https://www.readbyqxmd.com/read/27642848/optimal-use-of-wire-assisted-techniques-and-precut-sphincterotomy
#14
REVIEW
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
https://www.readbyqxmd.com/read/27550245/surgical-management-of-fistula-in-ano-among-patients-with-crohn-s-disease-analysis-of-outcomes-after-fistulotomy-or-seton-placement-single-center-experience
#15
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
https://www.readbyqxmd.com/read/27423057/surgical-management-of-fistulating-perianal-crohn-s-disease-a-uk-survey
#16
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. METHOD: 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...
March 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/27299638/papillary-cannulation-and-sphincterotomy-techniques-at-ercp-european-society-of-gastrointestinal-endoscopy-esge-clinical-guideline
#17
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
https://www.readbyqxmd.com/read/27129550/needle-knife-papillotomy-and-fistulotomy-improved-the-treatment-outcome-of-patients-with-difficult-biliary-cannulation
#18
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...
December 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/27102829/utility-of-needle-knife-fistulotomy-as-an-initial-method-of-biliary-cannulation-to-prevent-post-ercp-pancreatitis-in-a-highly-selected-at-risk-group-a-single-arm-prospective-feasibility-study
#19
Young-Joo Jin, Seok Jeong, Don Haeng Lee
BACKGROUND/AIMS: The aim of this study was to assess the feasibility of needle-knife fistulotomy (NKF) as an initial procedure for biliary access in patients with stones in the common bile duct (CBD) who were at increased risk for post-ERCP pancreatitis (PEP). METHOD: Fifty-five patients who underwent ERCP with NKF for CBD stones 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 sex, or normal CBD diameter (≤9 mm)...
November 2016: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/27092315/gaining-competence-in-needle-knife-fistulotomy-can-i-begin-on-my-own
#20
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
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