Male cryptoglandular fistula surgery outcomes: a retrospective analysis

Kondylis, Philip D.; Shalabi, Ahmed; Kondylis, Laurie Ann; Reilly, John C.

doi:10.1016/j.amjsurg.2008.11.002

Cited by 16 publications

(15 citation statements)

References 14 publications

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“…These extensions generally cross the midline pos- teriorly in the subsphincteric space (75% of cases), or, more rarely, anteriorly at the central fibrous core of the perineal body. Contralateral extension can also occur through the intersphincteric or supralevator spaces [5,8,10,14]. …”

Section: Diverticulamentioning

confidence: 98%

“…11) which will result in a gradual elastic fistulotomy [5,8,10,11,23,28,29]. The goal is to ''lower'' the fistulous tract by slowly cutting through the sphincter with progressive healing of the muscle fibers behind the seton (the same principle as a steel wire cutting through a block of ice).…”

Section: Fistulotomymentioning

confidence: 99%

“…at a second stage taking advantage of the fibrosis that has already formed around the seton to limit sphincteric retraction [7,11]. Surgical habits and experience determine the therapeutic choice because no formal conclusions can be drawn from the methodologically weak comparative studies published to date [3,10].…”

Section: Fistulotomymentioning

confidence: 99%

“…The sex ratio is 2-3 men per woman. The average age of onset is between 20 and 50 years [5][6][7][8][9][10][11].…”

Section: Epidemiologymentioning

confidence: 99%

“…The technique of fistulotomy varies depending on the height of sphincter encompassed by the fistulous tract: • A low intersphincteric or trans-sphincteric can usually be immediately laid open (one-stage fistulotomy) without risk to continence [5,7,8,10,11,13,[23][24][25][26][27].…”

Section: Fistulotomymentioning

confidence: 99%

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Cryptoglandular anal fistula

Parades

Zeitoun

Atienza

2010

Journal of Visceral Surgery

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Fistula arising from the glands of the anal crypts is the most common form of anoperineal sepsis. It is characterized by a primary internal orifice in the anal canal, a fistulous tract, and an abscess and/or secondary perineal orifice with purulent discharge. Antibiotics are not curative. The treatment of an abscess is urgent and consists, whenever possible, of incision and drainage under local anesthesia. Definitive treatment of the fistulous tract can await a second stage. The primary aim is to control infection without sacrificing anal continence. Fistulotomy is the basis for all treatments but the specific technique depends on the height of the fistula in relation to the sphincteric mechanism. Overall results of fistulotomy are excellent but there is some risk of anal incontinence. This explains the growing interest in sphincter sparing techniques such as the mucosal advancement flap, the injection of fibrin glue, and the plug procedure. However, results of these procedures are not yet good enough and leave much room for improvement.

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Section: Diverticulamentioning

confidence: 98%