New innovations in anal fistula surgery

Gilmore, Brian F.; Jackson, Katharine L.; Migaly, John

doi:10.1016/j.scrs.2019.100707

Cited by 4 publications

(1 citation statement)

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“…The therapy of anorectal fistula is a complex & contentious issue in the field of colorectal surgery (4) . Surgery is the mainstay of therapy with the aim of draining local infection eradicating the fistulous tract and prevention of recurrence while preserving native sphincter function (5) . The surgical approach is influenced by several factors such as the aetiology, location, type & duration of the fistula besides previously performed procedure and preoperative sphincter function (6) .…”

Section: Introductionmentioning

confidence: 99%

Modified Hanley Procedure for Management of Complex Posterior Horseshoe Anal Fistula

2024

The Egyptian Journal of Hospital Medicine

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Background: An anorectal fistula is a connection that is not normal among the epithelialized surface of the anal canal and most commonly the skin of the perianal region or the perineum. Surgery is the mainstay therapy aiming to drain local infection, to eliminate the fistulous tract and to avoid its recurrence while maintaining the function of the sphincter. Aim: This study aimed to evaluate the treated patients with horseshoe fistula of cryptoglandular origin utilizing a modified Hanley method involving a hybrid cutting one-stage approach. Methods: This prospective trial was done on twenty cases with chronic horseshoe fistula. All patients were subjected to preoperative PR examination to check for sphincter tone, preoperative MRI to demonstrate the extent of fistula and the deep post-anal space affection. Results: Regarding type of fistula, 3 (15%) persons had high trans-sphincteric fistula & 17 (85%) patients had low trans-sphincteric fistula. Seven (35%) patients had external opening from the anal verge within three centimetres and 13 (65%) patients had external opening from the anal verge beyond 3 cm. Out of the total number of individuals, three individuals (15%) had an internal opening located at the dentate line, while the remaining 17 individuals (85%) had an internal opening situated above the dentate line. Four (20%) patients had recurrence. Complete healing was achieved in all cases at 12 weeks post-operative period. Conclusions:The modified Hanley operation is effective and conservative surgical procedure that eliminates the disadvantage of keeping the seton for a long period and preserve the sphincter function.

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Section: Introductionmentioning

confidence: 99%