Combined Fistulotomy and Contralateral Anal Internal Sphincterotomy for Recurrent and Complex Anal Fistula to Prevent Recurrence

Handaya, Adeodatus Yuda; Fauzi, Aditya Rifqi

doi:10.3393/ac.2018.11.19

Cited by 4 publications

(2 citation statements)

References 9 publications

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“…While medical treatment is often helpful in relieving symptoms in patients with perianal abscess, surgical treatment can provide a more effective solution (6,7). Fistulotomy or This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to fistulectomy for superficial or anal fistulas that involve less than 30% of the external sphincter have a success rate of up to 92%-97% (8,9). On the other hand, treatment is more complex in patients with perianal fistula involving more than 30% of the external sphincter, suprasphincteric fistula, extrasphincteric fistula, or relapse.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of Partial Fistula Tract Excision with Loose Seton Application to Treat Perianal Fistula

Subaşı¹

2021

Erciyes Med J

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Section: Discussionmentioning

confidence: 99%

Effectiveness of Partial Fistula Tract Excision with Loose Seton Application to Treat Perianal Fistula

Subaşı¹

2021

Erciyes Med J

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“…The main treatment target for HAF patients focuses on healing of the fistula lesion, prevention of recurrence, and improvement of patients' bowel habits (5,6). In clinical practice, several methods have Original Article been introduced for the treatment of HAF, including fibrin sealant, fistula plug, ligation of intersphincteric fistula tract (LIFT), endorectal or dermal advancement flap, videoassisted anal fistula treatment, and traditional Chinese medicine (TCM) (7)(8)(9)(10)(11). However, the rate of healing after treatment remains extremely low (8,12).…”

Section: Introductionmentioning

confidence: 99%

Long-term follow-up study of loose combined cutting seton surgery for patients with high anal fistula

Zhi¹,

Huang²,

Liu³

et al. 2021

Ann Transl Med

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Background: The treatment of high anal fistula (HAF) is still difficult for clinical surgeons. Our previous study demonstrated the short-term benefit of loose combined cutting seton (LCCS) for patients with HAF.This study aimed to evaluate the long-term effectiveness of LCCS for treating HAF patients.Methods: We retrospectively enrolled consecutive HAF patients who received LCCS therapy in our hospital between March 2014 and July 2017. After enrollment, all patients were followed up by clinical review. The patients' clinical information and most recent follow-up results were collected. Pain was assessed by the visual analog scale (VAS), and the severity of fecal incontinence was assessed by the Wexner Continence Grading Scale. We also assessed the patients' quality of life (QOL) using a the MOS item short from health survey (SF-36) questionnaire. HAF healing was considered the primary outcome, while the fistula recurrence rate, severity of fecal incontinence, and QOL were the secondary outcomes.Results: In total, 22 patients (18 male, four female) were enrolled in the final analysis. The mean duration of follow-up was 3.65 years (interquartile range: 3.55-4.22; range, 3.50-5.43). All patients were cured and there was no recurrence during the follow-up period. Eight patients reported a Wexner score of 1, while the remaining patients reported a score of 0 at the final follow-up. Furthermore, one patient had a VAS score of 1, while the remaining patients had a VAS score of 0, which indicated almost no postoperative pain. The QOL of all patients improved significantly.Conclusions: LCCS is an effective method to treat HAF patients. Large, multicenter randomized controlled trials are warranted.

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Ligation of Intersphincteric Fistulous Tract vs Endorectal Advancement Flap for High-Type Fistula in Ano: A Randomized Controlled Trial

Kumar

Sarthak

Singh

et al. 2022

Journal of the American College of Surgeons

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BACKGROUND: This study aimed to compare the postoperative outcomes and success rate of the endorectal advancement flap and ligation of intersphincteric fistulous tract (LIFT) in high-type fistula in ano. STUDY DESIGN: This randomized control trial included patients with high-type fistula in ano of cryptoglandular origin. The primary endpoint was complete fistula healing at the end of 6 months. However, the patients were followed up for 2 years. Other parameters studied were perioperative complications, duration of surgery, postoperative pain, hospital stay in hours, continence, and quality of life at 6 months. RESULTS: A total of 84 patients were recruited (42 in each group). The healing rate in the LIFT arm was better than that in the endorectal advancement flap arm (76.2.% vs 54.7%, p = 0.039). Four patients in the endorectal advancement flap group and two in the LIFT group had flatus incontinence at the end of 6 months, but all were continent at 2 years. At the end of the first week, the Visual Analog Scale score and quality of life at 6 months were better in the LIFT arm (3.7 ± 1.16 vs 4.7 ± 0.81 and 0.7 vs 0.6, p < 0.05). The mean duration of surgery was significantly less in the LIFT group (46.43 ± 9.32 vs 89.29 ± 10.90 minutes). None had any postoperative complications, and >80% were discharged within 24 hours. CONCLUSIONS: The shorter operative duration, better quality of life at 6 months, and higher healing rate make LIFT a superior treatment option for high fistula in ano. However, studies with a large sample size will be needed to verify these results.

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Combined Fistulotomy and Contralateral Anal Internal Sphincterotomy for Recurrent and Complex Anal Fistula to Prevent Recurrence

Cited by 4 publications

References 9 publications

Effectiveness of Partial Fistula Tract Excision with Loose Seton Application to Treat Perianal Fistula

Effectiveness of Partial Fistula Tract Excision with Loose Seton Application to Treat Perianal Fistula

Long-term follow-up study of loose combined cutting seton surgery for patients with high anal fistula

Ligation of Intersphincteric Fistulous Tract vs Endorectal Advancement Flap for High-Type Fistula in Ano: A Randomized Controlled Trial

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