Evolution of Treatment of Fistula in Ano

Blumetti, Jennifer; Abcarian, Ariane M.; Quinteros, Francisco; Chaudhry, Vivek; Prasad, Leela M.; Abcarian, Herand

doi:10.1007/s00268-012-1480-9

Cited by 74 publications

(39 citation statements)

References 41 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Neben dem Fistelrezidiv mit der Notwendigkeit wiederholter Eingriffe beeinträchtigt insbesondere die Minderung der Kontinenzleistung die Zufriedenheit und die Lebensqualität [135,379]. Eine Aufarbeitung historischer Krankenunterlagen von Blumetti et al [45] [119].…”

Section: Kontinenzstörungen Nach Analfisteloperationenunclassified

S3 guidelines: cryptoglandular anal fistulas

Ommer¹,

Herold²,

Berg

et al. 2016

coloproctology

View full text Add to dashboard Cite

Section: Kontinenzstörungen Nach Analfisteloperationenunclassified

S3 guidelines: cryptoglandular anal fistulas

Ommer¹,

Herold²,

Berg

et al. 2016

coloproctology

View full text Add to dashboard Cite

“…Bu yöntemle tedavi oranları %90'larda bildirilmiştir. 4 Kompleks fistüller ise, eksternal sfinkterin %30'dan fazlasını içeren transsfinkterik fistüller, suprasfinkterik ve ekstrasfinkterik fistüller, enflamatuvar barsak hastalığının (İBH) eşlik ettiği fistüller, radyasyon etkisiyle oluşan fistüller, birden çok dış ağzı bulunan fistüller, kadınlarda anterior yerleşimli fistüller ile nüks fistülleri içerir. 5 Kompleks fistüllerin tedavisinde tam bir görüş birliği bulunmamaktadır.…”

Section: Introductionunclassified

Elastic Seton Placement in Treatment of Complex Anal Fistula: Analysis of 44 Patients

Bektaşoğlu¹,

Kunduz²

2018

TJCD

View full text Add to dashboard Cite

Amaç: Kompleks anal fistül tedavisinde konsensüs bulunmamaktadır. Çeşitli yöntemler bulunmakla birlikte tedavide sıklıkla seton uygulmaları yer alır. Setonlar sıkı ve gevşek olarak konabilir. Gevşek setonlar genellikle uzun süreli drenaj gereken vakarda tercih edilir. Sıkı setonlar ise ağrılı sıkma seansları ve kontinans üzerine olumsuz etkileri nedeniyle hasta konforunu düşürmektedir. Bu çalışmada, kompleks anal fistül tedavisinde sıkı seton alternatif olarak elastik seton uygulaması sonuçlarımızı paylaşmayı amaçladık. Yöntem: Ocak 2015-Aralık 2016 tarihleri arasında kliniğimize başvurup kompleks anal fistül nedeniyle opere edilen 48 hastanın verileri geriye dönük olarak incelendi. Demografik veriler, fistül detayları, enflamatuvar barsak hastalığı (İBH) öyküsü, apse varlığı, peroperatif detaylar, postoperatif komplikasyonlar, inkontinans ve rekürrens oranları incelendi. Bulgular: Çalışmaya elastik seton konan 44 hasta dahil edildi. İç ağız bulunamayan 4 hasta dışlandı. Hastaların 14'ü kadın, 30'u erkek olup ortanca yaş 43,5 yıl (18-83 yıl) olarak belirlendi. On dokuz hastada preoperatif apse vardı. Beş hastada İBH eşlik ediyordu. Ortanca operasyon süresi 22 dakika (11-50 dk), hastanede kalış süresi iki hasta dışında bir gündü. Postoperatif komplikasyon görülmedi. Yirmi beş hasta (%56,8) birinci ayın sonunda tek seansla iyileşti. Beş hastada seton yırtılması nedeniyle olmak üzere 18 hastada ikinci ve üçüncü kez operasyon gerekti. Bir hastada ise 5 kez operasyon gerekti. Üçüncü ay sonunda 40 hastada (%90,9) tam iyileşme gözlendi ve klinik olarak hiç bir hastada inkontinans gözlenmedi. Ortanca takip süresi 11 ay (6-21 ay) olup bu sürede 2 hastada (%4,5) rekürrens gelişti. Sonuç: Elastik seton uygulaması, ağrılı sıkma seanslarına gereksinim duyulmaması, bununla birlikte tatmin edici klinik başarısının olması nedeniyle kompleks anal fistüllerin tedavisinde sıkı setona alternatif olarak kullanılabilir. Anahtar Kelimeler: Anal fistül, kompleks fistül, seton, elastik seton ABSTRACT ÖZAim: There is no consensus on the treatment of complex anal fistula. Although there are various methods, the seton placement is commonly used in the treatment. Setons can be placed tight or loose. Loose setons are commonly used when prolonged drainage is required. Tight setons have disadvantages in terms of patient comfort due to painful tightening periods and adverse effects on continence. Method: The data of 48 patients admitted to our outpatient clinic and operated for complex anal fistula between January 2015 and December 2016 was retrospectively analyzed. Demographic data, fistula characteristics, coexisting inflammatory bowel disease (IBD), abscess formation, perioperative details, postoperative complications, and incontinence and recurrence rates were evaluated. Results: Forty-four patients who underwent elastic seton placement were enrolled in the study. Four patients for whom the internal opening could not be identified were excluded. The female to male ratio was 14/30 and median age was 43.5 years (18-83 years). There were absce...

show abstract

“…When fistulae are treated by aggressive surgery it may result in high healing rates, however, this management is associated with the risk of sphincter damage and incontinence but if dealt with in a less aggressive way this may increase the danger of recurrence. 1 For the simple intersphincteric or transsphincteric low fistula surgical treatment such as fistulotomy or fistulectomy is mostly curative with a success rate reaching up to 100%cure rates. 2 For complex, recurrent and branching fistulae minimallyinvasive treatment such as fibrin sealants and pigcollagen plugs proved to be not highly successful.…”

Section: Introductionmentioning

confidence: 99%

Autologous bone marrow derived stem cells in the treatment of complex anal fistula

Raslan

Ayoub

2018

Int Surg J

View full text Add to dashboard Cite

Background: Treatment of anal fistula shows a great conflict between preservation of continence and eradication of sepsis. Stem cells extracted from bone marrow are able to home to inflamed tissues and repair injured ones. The aim of this study is to present the early results of injection of stem cells to tracts of complex recurrent fistulae. The primary outcome of the study is the healing of the complex fistula secondary outcomes include safety profile of the procedure.Methods: 15 patients having complex anal fistulae. To prepare stem cells, bone marrow aspiration was performed under complete aseptic conditions. After several steps for isolation, viability testing and preparation, stem cells were suspended in sterile saline for injection in the patients. The internal opening was identified and closed then curettage of the tract with injection of cell suspension simultaneous with fibrin glue followed by injection of stem cell suspension around the tract and external opening finally it was closed. The first evaluation was performed after 8 weeks, a final evaluation after one year.Results: Categorized into three groups (a) complete healing 8 patients (53.3%). (b) Incomplete healing 4 patients (26.7%) (c) Recurrence 3 patients (20%) No incontinence, abnormal tissue growth or major adverse effects were reported.Conclusions: Use of autologous bone marrow-derived stem cells in anal fistula treatment is a recent modality with variable rates of success. Despite the rate of failure or incomplete healing but it still provides a solution to avoid continence impairment. It needs better evaluation with larger sample size, with long-term follow up. literatures.

show abstract

Evolution of Treatment of Fistula in Ano

Cited by 74 publications

References 41 publications

S3 guidelines: cryptoglandular anal fistulas

S3 guidelines: cryptoglandular anal fistulas

Elastic Seton Placement in Treatment of Complex Anal Fistula: Analysis of 44 Patients

Autologous bone marrow derived stem cells in the treatment of complex anal fistula

Contact Info

Product

Resources

About