Fistula-in-ano is usually simple to manage surgically

Shouler, P. J.; Grimley, R P; Keighley, M. R. B.; Alexander-Williams, J

doi:10.1007/bf01648418

Cited by 89 publications

(50 citation statements)

References 2 publications

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“…Most fistulas in ano are easily managed by surgery alone 11 , although MRI is useful in complex cases. Lunniss et al 4 found that MRI could classify cryptoglandular fistula and also predict relapse with greater accuracy than EUA.…”

Section: Discussionmentioning

confidence: 99%

Magnetic resonance imaging for primary fistula in ano

Buchanan

Halligan

Williams

et al. 2003

British Journal of Surgery

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Section: Discussionmentioning

confidence: 99%

Magnetic resonance imaging for primary fistula in ano

Buchanan

Halligan

Williams

et al. 2003

British Journal of Surgery

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“…A simple laying open procedure is effective for low or simple fistulas [26] . However, treatment of complex anal fistulas is challenging because internal and external sphincters are involved in the fistulous track and fecal continence could be impaired after surgery [27,28] .…”

Section: Discussionmentioning

confidence: 99%

Anal fistula plug vs mucosa advancement flap in complex fistula-in-ano: A meta-analysis

Jin²

2012

WJGS

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AIM:To investigate the efficacy of the anal fistula plug (AFP) compared to the mucosa advancement flap (MAF), considered the best procedure for patients with a complex anal fistula. METHODS:The literature search included PubMed, EMBASE, Cochrane Library and OVID original studies on the topic of AFP compared to MAF for complex fistula-in-ano that had a deadline for publication by April 2011. Randomized controlled trials, controlled clinical trials and prospective cohort studies were included in the review. After information collection, a meta-analysis was performed using data on overall success rates as well as incidence of incontinence and morbidity. The quality of postoperative life was also included with the clinical results. RESULTS:Six studies involving 408 patients (AFP = 167, MAF = 241) were included in the meta-analysis. The differences in the overall success rates and incidence of fistula recurrence were not statistically significant between the AFP and MAF [risk difference (RD) = -0.12, 95%CI: -0.39 -0.14; RD = 0.13; 95%CI: -0.18 -0.43, respectively]. However, for the AFP, the risk of postoperative impaired continence was lower (RD = -0.08, 95%CI: -0.15 --0.02) as was the incidence of other complications (RD = -0.06, 95%CI: -0.11 --0.00). The postoperative quality of life, for patients treated using the AFP was superior to that of the MAF patients. Patients treated with the AFP had less persistent pain of a shorter duration and the healing time of the fistula and hospital stay were also reduced. CONCLUSION:The AFP is an effective procedure for patients with a complex anal fistula; it has the same success rate but a lower risk of complications than the MAF and may also be associated with an improved postoperative quality of life. Additional evidence is needed to confirm these findings.

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“…Patients may also have systemic sepsis. There are many therapeutic options for anal fistula; however, fistulotomy, which involves division of all tissues encircled by the fistula, has a cure rate of over 90%, 3 and is the mainstay of treatment. There is nevertheless a risk of rendering the patient incontinent when the anal sphincter is divided.…”

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confidence: 99%

Quality of life with anal fistula

Owen

Buchanan

Schizas

et al. 2016

annals

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INTRODUCTION Anal fistula affects people of working age. Symptoms include abscess, pain, discharge of pus and blood. Treatment of this benign disease can affect faecal continence, which may, in turn, impair quality of life (QOL). We assessed the QOL of patients with cryptoglandular anal fistula. METHODS Newly referred patients with anal fistula completed the St Mark's Incontinence Score, which ranges from 0 (perfect continence) to 24 (totally incontinent), and Short form 36 (SF-36) questionnaire at two institutions with an interest in anal fistula. The data were examined to identify factors affecting QOL. RESULTS Data were available for 146 patients (47 women), with a median age of 44 years (range 18-82 years) and a median continence score of 0 (range 0-23). Versus population norms, patients had an overall reduction in QOL. While those with recurrent disease had no difference on continence scores, QOL was worse on two of eight SF-36 domains (p<0.05). Patients with secondary extensions had reduced QOL in two domains (p<0.05), while urgency was associated with reduced QOL on five domains (p<0.05). Patients with loose seton had the same QOL as those without seton. No difference in urgency was found between patients with and without loose seton. In primary fistula patients, 19.4% of patients experienced urgency versus 36.3% of those with recurrent fistulas. CONCLUSIONS Patients with anal fistula had a reduced QOL, which was worse in those with recurrent disease, secondary extensions and urgency. Loose seton had no impact on QOL.

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Fistula-in-ano is usually simple to manage surgically

Cited by 89 publications

References 2 publications

Magnetic resonance imaging for primary fistula in ano

Magnetic resonance imaging for primary fistula in ano

Anal fistula plug vs mucosa advancement flap in complex fistula-in-ano: A meta-analysis

Quality of life with anal fistula

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