Sphincter-Sparing Anal Fistula Repair: Are We Getting Better?

Sugrue, Jeremy; Mantilla, Nathalie; Abcarian, Ariane M.; Kochar, Kunal; Marecik, Sławomir; Chaudhry, Vivek; Mellgren, Anders; Nordenstam, Johan

doi:10.1097/dcr.0000000000000885

Cited by 51 publications

(30 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Sugrue 15 , presenta un trabajo retrospectivo en que compara sellante, plugs, LIFT, dermal flap, rectal flap. Flap y LIFT presentaron los mejores resultados.…”

Section: Ligadura Interesfinteriana Del Trayecto Fistuloso (Lift)unclassified

Manejo de la fístula anorrectal compleja. LIFT, colgajo de avance y otras técnicas.

Vallejos

Ocaranza

2020

Rev. Cirugia

View full text Add to dashboard Cite

Las fístulas anorrectales complejas son un desafío para el coloproctólogo. Son una patología frecuente que afecta la calidad de vida de los pacientes. La patogénesis aún no esta clara, estarían involucradas citoquinas y el proceso de transición de epitelio a mesénquima. El gold estandar para su estudio es la resonancia nuclear magnética, su uso por si mismo disminuye la recurrencia. El objetivo del tratamiento es lograr la curación sin afectar la función del esfínter evitando las recidivas. Existen múltiples técnicas, siendo la de mayor aceptación la ligadura interesfinteriana del trayecto fistuloso, con tasa de curación sobre el 70%, con mínimo impacto en continencia. Esta revisión incluye otras técnicas como el colgajo endorrectal de avance, uso de sellante, Permacol, células madres, Anal fistula plug, Video asisted anal fistula treatment, Over the scope clip y Fístula laser closure.

show abstract

“…Sugrue 15 , presenta un trabajo retrospectivo en que compara sellante, plugs, LIFT, dermal flap, rectal flap. Flap y LIFT presentaron los mejores resultados.…”

Section: Ligadura Interesfinteriana Del Trayecto Fistuloso (Lift)unclassified

Manejo de la fístula anorrectal compleja. LIFT, colgajo de avance y otras técnicas.

Vallejos

Ocaranza

2020

Rev. Cirugia

View full text Add to dashboard Cite

show abstract

“…Although most patients can be cured by surgical operation, the treatment of complex anal fistula remains a big challenge because of high lesion location, pipe bend, and dead space, with a high rate of recurrence and frequent side effects, especially as fecal incontinence [ 3 – 5 ]. Minimally invasive surgery of anal fistula is an emergence, and there are several sphincter-sparing surgeries in the past 20 years, but the most suitable surgical treatment has not been determined [ 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

Autologous adipose-derived stem cells for the treatment of complex cryptoglandular perianal fistula: a prospective case-control study

Zhang

Zhou

et al. 2020

Stem Cell Res Ther

View full text Add to dashboard Cite

Background Complex cryptoglandular perianal fistula (CPAF) is a kind of anal fistula that may cause anal incontinence after surgery. Minimally invasive surgery of anal fistula is constantly emerging. Over the past 20 years, there are several sphincter-sparing surgeries, one of which is autologous adipose-derived stem cell (ADSC) transplantation. However, to date, there is no study regarding the treatment of complex CPAF with ADSC in China. This is the first study in China on the treatment of complex CPAF with ADSC to evaluate its safety and efficacy. Methods Totally, 24 patients with complex CPAF were enrolled in this prospective case-control study from January 2018 to December 2019 in the National Colorectal Disease Center of Nanjing Hospital of Chinese Medicine Affiliated to Nanjing University of Chinese Medicine. Patients were divided into ADSC group and endorectal advancement flap (ERAF) group according to their desire. The healing of fistulas (healing of all treated fistulas at baseline, confirmed by doctor’s clinical assessment and magnetic resonance imaging or transrectal ultrasonography) was evaluated at week 12 after treatment. In addition to their safety evaluation based on adverse events monitored at each follow-up, the patients were also asked to complete some scoring scales at each follow-up including pain score with visual analog score (VAS) and anal incontinence score with Wexner score. Results The closure rates within ADSC group and ERAF group at week 12 were 54.55% (6/11) and 53.85% (7/13), respectively, without significant difference between them. VAS score in ADSC group was significantly lower than that in ERAF group at the 5th day postoperatively [1(0,2) VS 2(2,4), p = 0.011], but no differences were observed at the other time. Wexner score of all patients was not increased with no significant differences between the two groups. Adverse events were observed fewer in ADSC group (27.27%) than that in ERAF group (53.85%), but there was no significant difference between them. Conclusion This study indicated safety and efficiency of ADSC for the treatment of complex CPAF in the short term, which is not inferior to that of ERAF. ADSC may provide a promised and potential treatment for complex CPAF conforming to the future of the treatment, which is reconstruction and regeneration. Trail registration ChiCTR, ChiCTR1800014599. Registered 23 January 2018—retrospectively registered, http://www.chictr.org.cn/showproj.aspx?proj=24548

show abstract

“…6 Therefore, there has been a considerable interest in the development of sphincter-sparing repair procedures as fistulotomy in complex fistulas will result in fecal incontinence. 7 The interventional studies evaluating the effectiveness of interventions for anal fistula show heterogeneity in outcome reporting. In addition, there is considerable variability in outcome definitions, outcome measurement instruments, and timing of outcome assessment.…”

Section: Introductionmentioning

confidence: 99%

The development of a cryptoglandular Anal Fistula Core Outcome Set (AFCOS): an international Delphi study protocol

et al. 2020

View full text Add to dashboard Cite

Purpose: Cryptoglandular anal fistula is a disorder with an incidence of around 1 per 5,000 people per year in European countries. Many studies have been conducted to evaluate the effectiveness of interventions for anal fistula. However, there is considerable heterogeneity in the outcomes assessed and reported in these studies. This limits research quality and complicates evidence synthesis. A solution for heterogeneity in outcome reporting is the development of a Core Outcome Set (COS). This paper describes the protocol for the development of a European COS for Anal Fistula (AFCOS). Methods: The first step will be a systematic review of the literature to identify potential outcomes that may be included in the COS. Patient interviews will be conducted in The United Kingdom and The Netherlands to ensure that both clinician-important and patient-important outcomes are captured. The outcomes will be categorized using the COMET taxonomy and taken forward to a Delphi consensus exercise. In up to three web-based Delphi surveys the outcomes will be prioritized by patients, clinicians (surgeons, gastroenterologists, and radiologists), and (clinical) researchers. The responses will be summarized and reported anonymously in subsequent round(s) facilitating convergence to a consensus opinion. The final COS will be decided during a face-to-face consensus meeting with patients, clinicians, and (clinical) researchers. Discussion: This study protocol describes the development of a European COS for anal fistula to improve research quality, evidence synthesis, and patient care.

show abstract

Sphincter-Sparing Anal Fistula Repair: Are We Getting Better?

Cited by 51 publications

References 35 publications

Manejo de la fístula anorrectal compleja. LIFT, colgajo de avance y otras técnicas.

Manejo de la fístula anorrectal compleja. LIFT, colgajo de avance y otras técnicas.

Autologous adipose-derived stem cells for the treatment of complex cryptoglandular perianal fistula: a prospective case-control study

The development of a cryptoglandular Anal Fistula Core Outcome Set (AFCOS): an international Delphi study protocol

Contact Info

Product

Resources

About