Incision and drainage of perianal abscess with or without treatment of anal fistula

Malik, Ali Irqam; Nelson, Richard L.; Tou, Samson

doi:10.1002/14651858.cd006827

Cited by 37 publications

(47 citation statements)

References 10 publications

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“…There was a comparatively low incidence of abscess recurrence at 8 weeks, with high fistula rates observed at 6 months. The previously reported frequency of recurrent or fistulating disease varies widely, from 5 to 37 per cent 5,15,20,26 . As more than one in five patients with a primary perianal abscess in the present study had a fistula in ano, it could be considered appropriate to follow up all patients routinely after surgery.…”

Section: Discussionmentioning

confidence: 99%

Multicentre observational study of outcomes after drainage of acute perianal abscess

Pearce

Newton

Smith

et al. 2016

British Journal of Surgery

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Section: Discussionmentioning

confidence: 99%

Multicentre observational study of outcomes after drainage of acute perianal abscess

Pearce

Newton

Smith

et al. 2016

British Journal of Surgery

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“…The findings might reflect low mortality in this disease entity and effect of spontaneous pustular drainage or surgical debridement for better infection control. Meta-analysis by Malik and colleagues showed fistula surgery with abscess drainage significantly reduces recurrence or persistence of abscess fistula in general population [21]. The recurrence rate is 3 to 5% in the general population [17], [22].…”

Section: Discussionmentioning

confidence: 99%

Clinical and Microbiological Characteristics of Perianal Infections in Adult Patients with Acute Leukemia

et al. 2013

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BackgroundPerianal infection is a common problem for patients with acute leukemia. However, neutropenia and bleeding tendency are relatively contraindicated to surgical intervention. The epidemiology, microbiology, clinical manifestations and outcomes of perianal infection in leukemic patients are also rarely discussed.MethodThe medical records of 1102 adult patients with acute leukemia at a tertiary medical center in Taiwan between 2001 and 2010 were retrospectively reviewed and analyzed.ResultThe prevalence of perianal infection was 6.7% (74 of 1102) in adult patients with acute leukemia. Twenty-three (31%) of the 74 patients had recurrent episodes of perianal infections. Patients with acute myeloid leukemia had higher recurrent rates than acute lymphoblastic leukemia patients (p = 0.028). More than half (n = 61, 53%) of the perianal infections were caused by gram-negative bacilli, followed by gram-positive cocci (n = 36, 31%), anaerobes (n = 18, 15%) and Candida (n = 1, 1%) from pus culture. Eighteen patients experienced bacteremia (n = 24) or candidemia (n = 1). Overall 41 (68%) of 60 patients had polymicrobial infection. Escherichia coli (25%) was the most common micro-organism isolated, followed by Enterococcus species (22%), Klebsiella pneumoniae (13%), and Bacteroides species (11%). Twenty-five (34%) of 74 patients received surgical intervention. Acute leukemia patients with surgically managed anal fistulas tended to have fewer recurrences (p = 0.067). Four (5%) patients died within 30 days after diagnosis of perianal infection. Univariate analysis of 30-day survival revealed the elderly (≧ 65 years) (p = 0.015) and patients with shock (p<0.001) had worse outcome. Multivariate analysis showed septic shock to be the independent predictive factor of 30-day crude mortality of perianal infections (p = 0.016).ConclusionPerianal infections were common and had high recurrence rate in adult patients with acute leukemia. Empirical broad-spectrum antibiotics with anaerobic coverage should be considered. Shock independently predicted 30-day crude mortality. Surgical intervention for perianal infection remains challenging in patients with acute leukemia.

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“…Two meta-analyses have considered the question of immediate fistula treatment at acute anorectal abscess drainage. Quah et al [101] examined five randomized controlled trials (RCTs) and a subsequent Cochrane review added a sixth non-English language trial [102]. Both identified lower recurrence rates of anorectal sepsis (abscess or fistula) with immediate fistula treatment.…”

Section: Recommendationsmentioning

confidence: 99%

The treatment of anal fistula: secondACPGBIPosition Statement – 2018

Williams

Tozer

et al. 2018

Colorectal Disease

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Incision and drainage of perianal abscess with or without treatment of anal fistula

Cited by 37 publications

References 10 publications

Multicentre observational study of outcomes after drainage of acute perianal abscess

Multicentre observational study of outcomes after drainage of acute perianal abscess

Clinical and Microbiological Characteristics of Perianal Infections in Adult Patients with Acute Leukemia

The treatment of anal fistula: secondACPGBIPosition Statement – 2018

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