Anatomic Characteristics of Anal Fistula on Three-Dimensional Anorectal Ultrasonography

Murad-Regadas, Sthela M.; Regadas, Francisco Sérgio Pinheiro; Rodrigues, Lusmar Veras; Fernandes, Graziela Olívia da Silva; Buchen, Guilherme; Kenmoti, Viviane Tiemi; Soares, Gabriel dos Santos Dias; Holanda, Erico de Carvalho

doi:10.1007/dcr.0b013e3182060c84

Cited by 10 publications

(6 citation statements)

References 21 publications

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“…24 The diagnostic value of 3D-EAUS in patients with fistula in ano is represented by the accurate ultrasound identification and depiction of the main fistula characteristics including internal orifice, primary tract and secondary extensions. 25,26 In our series failure to identify the internal opening, as detected by 3D-EAUS, represented, according with literature, [27][28][29][30][31][32][33] a relevant risk factor for unsuccessful surgery whereas failure in detecting fistula primary tract and secondary extensions showed a lower prognostic value. However, as regards the primary tracts classification, the difference in the success rate between patients with concordant and discordant ultrasound and surgical findings were considerable (12%), suggesting a potential statistical significance in a larger patients sample size.…”

Section: Discussionsupporting

confidence: 66%

Impact of Preoperative Three-Dimensional Endoanal Ultrasound on the Surgical Outcome of Primary Fistula in Ano. A Multi-Center Observational Study of 253 Patients

Brillantino,

Iacobellis,

Brusciano

et al. 2023

Surg Innov

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Purpose To evaluate the impact of preoperative three-dimensional endoanal ultrasound (3D-EAUS) on the clinical outcome of anal fistula surgery. Methods The research consisted of multi-center retrospective case-control study including 253 consecutive adult patients undergoing surgery for confirmed or suspected primary fistula in ano who had undergone preoperative 3D-EAUS evaluation between January 2011 and January 2021. Main outcome measures were the concordance (K value) between ultrasound results and surgery in the identification of fistulas internal openings, primary tracts and secondary extensions and the 6 and 12 months success rate in patients with concordant and discordant findings. Results A good agreement in the identification of the main fistulas characteristics between ultrasound results and operative findings was found. A significant difference ( P < .0001; Fisher’s exact test) in the success rate was found between patients with concordant and discordant ultrasound results and operative findings in identification or location of internal opening. Particularly, all the 11 (4.8%) patients with discordant results experimented a failure of the surgical procedure at 6 months follow-up. At re-operation, the shift from discordant to concordant results was associated with an 81.8% 12 months success-rate. Conclusion The three-dimensional endoanal ultrasound preoperative evaluation may have a relevant impact on the outcome of a defined group of patients undergoing surgery for anal fistula, since the careful evaluation of ultrasound results could simplify the internal orifice intra-operative detection and improve the success rate.

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Section: Discussionsupporting

confidence: 66%

Impact of Preoperative Three-Dimensional Endoanal Ultrasound on the Surgical Outcome of Primary Fistula in Ano. A Multi-Center Observational Study of 253 Patients

Brillantino,

Iacobellis,

Brusciano

et al. 2023

Surg Innov

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“…, with a success rate of 43% in 42 plug insertions, regardless of location, found any association between healing and the position of the fistula tract. Anterior fistulae are recognized to be difficult to treat, especially in women , and the precise reason for the lower success of treatment is unknown .…”

Section: Discussionmentioning

confidence: 99%

“…In contrast, neither Cintron et al [24], with success rates of 35% in 40 anterior fistulae and 37% in 38 posterior or lateral fistulae, nor McGee et al [29], with a success rate of 43% in 42 plug insertions, regardless of location, found any association between healing and the position of the fistula tract. Anterior fistulae are recognized to be difficult to treat, especially in women [1], and the precise reason for the lower success of treatment is unknown [30].…”

Section: Discussionmentioning

confidence: 99%

Results of collagen plug occlusion of anal fistula: a multicentre study of 126 patients

et al. 2014

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“…Complementing it with colonoscopy is mandatory in case of suspected inflammatory disease, doubts about the diagnosis and in those patients indicated to be tracked for neoplasm. Other complementary methods for assessment have been employed, such as nuclear magnetic resonance and anorectal ultrasound in order to contribute to the planning of surgical technique 7,8,15,16 . In the current study, the predominance of transsphincteric fistulas has been observed; although different from the ones mentioned by Parks, Gordon and Hardcastle…”

Section: Discussionmentioning

confidence: 99%

Anal fistula: results of surgical treatment in a consecutive series of patients

Oliveira¹,

Sousa²,

Almeida³

et al. 2012

J. Coloproctol. (Rio J.)

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Objectives:To evaluate the results of surgical treatment of patients with anal fistulas in a consecutive series of patients. Methods: A retrospective analytical study of a consecutive series of cases prospectively collected. The sample comprised 210 patients who underwent surgery; demographic data, signs and symptoms, intraoperative classification of the fistulas and healing time were analyzed. results: The median age was 38 years and 69.0% of the patients were male. The most frequent symptom was perianal orifice with purulent drainage. The fistulas were classified as transsphincteric in 60.9% and the most used operative treatment was the marsupialization of fistulotomy, in 84.2% of cases. Complete healing occurred in all patients between 2 and 16 weeks. One hundred and seventy-eight patients, 84.8% of the patients who underwent surgery, were evaluated at least one year after surgery and recurrence occurred in 6.4% of cases. Conclusions: There was male prevalence (2.2/1), and most fistulas were transsphincteric. The marsupialization of fistulotomy was the most used operative treatment, and it presented acceptable low rates of morbidity and recurrence of 6.4%.Keywords: fistula; rectal fistula; surgery; classification; surgical treatment, operative. resuMO: Objetivos: Avaliar os resultados do tratamento cirúrgico de pacientes portadores de fístulas anais em uma série consecutiva de pacientes. Métodos: Estudo analítico, retrospectivo, de uma série consecutiva de casos que foram coletados de forma prospectiva. A casuística englobou 210 pacientes operados, tendo sido analisados os dados demográficos, os sinais e sintomas, a classificação transoperatória das fístulas e o tempo até a cicatrização completa. resultados: A mediana de idade foi de 38 anos e 69,0% dos pacientes eram homens. O sintoma mais frequente foi a drenagem de secreção purulenta por orifício perianal. As fístulas foram classificadas como transesfincterianas em 60,9%, e o tratamento operatório mais empregado foi a fistulotomia com marsupialização do trajeto fistuloso, em 84,2% dos casos. A cicatrização completa ocorreu em todos os pacientes entre 2 e 16 semanas. Cento e setenta e oito pacientes, 84,8% dos pacientes operados, foram avaliados com, pelo menos, um ano de pós-operatório e a recidiva ocorreu em 6,4% dos casos. Conclusões: Houve prevalência do gênero masculino (2,2/1) com a maioria das fístulas transesfincterianas. A fistulotomia com marsupialização foi o tratamento operatório mais empregado e apresentou baixos índices de morbidade, com recidiva de 6,4%.

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Anatomic Characteristics of Anal Fistula on Three-Dimensional Anorectal Ultrasonography

Cited by 10 publications

References 21 publications

Impact of Preoperative Three-Dimensional Endoanal Ultrasound on the Surgical Outcome of Primary Fistula in Ano. A Multi-Center Observational Study of 253 Patients

Impact of Preoperative Three-Dimensional Endoanal Ultrasound on the Surgical Outcome of Primary Fistula in Ano. A Multi-Center Observational Study of 253 Patients

Results of collagen plug occlusion of anal fistula: a multicentre study of 126 patients

Anal fistula: results of surgical treatment in a consecutive series of patients

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