Non-sphincter splitting fistulectomy vs conventional fistulotomy for high trans-sphincteric fistula-in-ano: a prospective functional and manometric study

Toyonaga, T.; Matsushima, Makoto; Tanaka, Yoshiaki; Suzuki, Kazunori; Sogawa, Nobuhito; Kanyama, Hiroki; Shimojima, Yasuhiro; Hatakeyama, Tomoaki; Tanaka, Masao

doi:10.1007/s00384-007-0288-9

Cited by 27 publications

(19 citation statements)

References 25 publications

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“…18 The criteria determining success or failure of surgery are incidence of recurrence or incontinence. 19 In present study 16 patients were treated for fistula in ano.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of ligation of intersphincteric fistula tract (LIFT) in the management of fistulas in ano

Rohit

Jain²,

Pandey

2017

Int Surg J

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Background: Fistula in ano is an abnormal connection between the epithelized surface of anal canal and usually the perianal skin. It is a benign treatable lesion of rectum and anal canal. Crypto glandular infection accounts for about ninety percent of the cases. The estimated prevalence of an anal fistula is 12 to 28/1000000 of the population per year with male to female ratio 1.8:1. Ligation of intersphincteric fistula tract is a new sphincter saving method with good result in the management of anal fistula. The aim of study was to evaluate the effectiveness and functional outcomes of the ligation of intersphinteric fistula tract (LIFT).Methods: This prospective study includes sixteen patients who were operated for fistulas in ano at Bundelkhand Medical College and Associated Hospital, Sagar from January 2015 to June 2017. Patients above the age of 20 years, proved cases of fistulas in ano without co-morbid conditions and no previous surgical intervention were included in the study. Patients presenting with fistulas from another source such as crohn’s disease, tuberculosis, anal cancer and recurrent fistulas were excluded. A detailed history, clinical presentation, digital rectal examination, anal ultrasound and routine investigations were done in all cases.Results: In the present study most of the patients were male and presents with perianal discharge. The diagnosis is made by clinical history, per rectal examination and anal ultrasonography. All the sixteen patients with fistula in ano underwent ligation of intersphincteric fistula tract (LIFT). The patients were followed for a period of three months. Most of the cases (87.5%) healed within 4-6 weeks. The recurrence of fistula occurs in four cases (25%). Recurrence is due to infection and technical error in the procedures. There were no deaths in the study.Conclusions: The LIFT technique proved to be safe and effective in the treatment of fistula in ano.

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“…18 The criteria determining success or failure of surgery are incidence of recurrence or incontinence. 19 In present study 16 patients were treated for fistula in ano.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of ligation of intersphincteric fistula tract (LIFT) in the management of fistulas in ano

Rohit

Jain²,

Pandey

2017

Int Surg J

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“…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: 98%

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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“…Eine prospektiv-randomisierte Studie [500] Weitere aktuelle Arbeiten bestätigen die Veränderung der anorektalen Morphologie und Minderung der Kontinenz durch Eingriffe sowohl bei oberflächli-chen [435] als auch bei hohen Analfisteln [348]. Kontinenzstörungen können sich auch noch nach Jahren durch eine Summierung von Vorschäden und Alterungsvorgängen manifestieren.…”

Section: Kontinenzstörungen Nach Analfisteloperationenunclassified