Avaliação por ressonância magnética das fístulas perianais: ensaio iconográfico

Lima, Cláudio Márcio Amaral de Oliveira; Junqueira, Flávia Pegado; Rodrigues, Mônica Cristina Salazar; Gutierrez, César Augusto Salazar; Domingues, Romeu Côrtes; Coutinho, Antônio Carlos

doi:10.1590/s0100-39842010000500013

Cited by 5 publications

(2 citation statements)

References 6 publications

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“…Trans-sphincteric anal fistulae involving more than 30% of the external sphincter, although they may be treated by various techniques, have a proportionally higher cure rate as the risk of fecal incontinence increases 1 , 13 , 14 . The evaluation and classification in clinical practice can be done by magnetic resonance or endoanal ultrasound 10 , 15 .…”

Section: Introductionmentioning

confidence: 99%

Primary Sphincteroplasty Comparing Two Different Stitches in Anal Fistula Treatment: Experimental Study in Rats

Tanus

Santos

Dourado

et al. 2019

ABCD, arq. bras. cir. dig.

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Background: Anal fistula is by definition the communication between the rectum or anal canal with the perineal region, which may be epithelialized and has cryptoglandular origin in 90% of cases. There are a large number of techniques for successfully treating trans-sphincteric fistulas of 20-50%, including primary sphincteroplasty, but it is not clear whether the material used would influence the outcome. Aim: To analyze the efficacy of polydioxanone and polypropylene wire in primary post-fistulotomy sphincteroplasty in the treatment of trans-sphincteric fistulas in rats. Methods:Thirty Wistar rats had transfixation of the anal sphincter with steel wire, which remained for 30 days for the development of the anal fistula. After this period, it was removed and four groups were formed: A (control) without treatment; B (fistulotomy) submitted to such procedure and curettage only; C (polidioxanone) in which sphincteroplasty was performed after fistulotomy with polydioxanone wire; D (polypropylene) submitted to the same treatment as group C, but with polypropylene wire. After 30 days, euthanasia and removal of the specimens were performed for qualitative histopathological analysis, measurement of the area between the muscular cables edges and evaluation of the degree of local fibrosis. Results: There was persistence of the anal fistula in all animals of group A. There were no significant differences between groups B, C and D regarding the distance of the muscular cables (p=0.078) and the degree of fibrosis caused by the different treatments (p=0.373). Conclusions:There was no difference between polydioxanone and polypropylene wires in post-fistulotomy primary sphincteroplasty, and this technique was not superior to simple fistulotomy in relation to the distance of the muscular cables nor did it present differences in relation to the degree of local fibrosis.

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Section: Introductionmentioning

confidence: 99%

Primary Sphincteroplasty Comparing Two Different Stitches in Anal Fistula Treatment: Experimental Study in Rats

Tanus

Santos

Dourado

et al. 2019

ABCD, arq. bras. cir. dig.

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“…Male female ratio is 2:1. 2 On and off perianal discharge, itching, discomfort, fever and local pain are the common symptoms. 3,4 Even though being an uncommon disease, Fistula-in-ano was first described in Hippocrates.…”

Section: Introductionmentioning

confidence: 99%

3T MR imaging evaluation of perianal fistulas: an initial experience in Nepal

Gurung

2016

J. Soc. Surg. Nepal

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Introduction: Fistula–in–ano is an abnormal perianal tract that connects anal canal to the perianal skin. Improper visualization of primary fistulous tract and the associated abscesses or secondary tracts a r e the causes of recurrence. Earlier imaging modalities like conventional fistulography, endosonography and CT scan have had limited role. Even without endorectal coils, 3T MRI has multi-planar imaging capability and excellent soft tissue differentiation to show perianal anatomy, primary and secondary tracts with associated abscesses in relation to sphincter complex. It provides excellent road map to surgeons for preoperative evaluation. The objective of the study was to evaluate the role of 3T MR in imaging of perianal fistulas. Methods: A retrospective study was done among 32 patients who were referred for MR fistulogram for suspected perianal fistula at Jeebanta Advanced Kathmandu Imaging, Durbar Marg, Kathmandu, Nepal. All images and findings were obtained and recorded with the help of Philips Ingenia 3T digital broadband MR scanner. Imaging was performed in oblique coronal and oblique axial plane. MR images were studied and grading system was applied according to the St James’s University Hospital Classification. The data were entered in a performa and was analyzed using IBM SPSS V21. Results: Male to female ratio was 7:1. According to St. James University Hospital MR Imaging classification of perianal fistulas, most of the patients (25%) had Grade 4 followed by (12.5% each) Grade 0, Grade 1 and Grade 2 and (6.3% each) Grade 3 and Grade 5 fistulas. Mean age was 37.28 years (Std. deviation 11.9). Common internal opening in axial image was found at 5 0’ clock positions (31.3%). Mean length of the fistulous tract was 3.9 cm (Std. deviation 2.3). Conclusion: Perianal fistulas are more common in males and Grade 4 fistulas are the commonest. MRI is well-tolerated, painless and non-invasive technique and has multiplanar capabilities with excellent tissue differentiation of pelvic muscle along with sphincter complex.

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