Utility of Endoanal Ultrasonography in Assessment of Primary and Recurrent Anal Fistulas and for Detection of Associated Anal Sphincter Defects

Abstract

The diagnostic utility of 3D-EAUS was comparable in primary and recurrent FIA. 3D-EAUS was able to detect symptomatic and occult AS defects with higher accuracy than clinical examination.

Effects of preoperative endoanal ultrasound on functional outcome after anal fistula surgery

“…Thus, the usefulness of EAUS in non-simple fistula in preservation of anal continence has been confirmed 8 9. The explanation of a lesser change in FISS may be due to information obtained from EAUS that helped surgeons in decision-making and avoid extensive exploration during operation that may lead to sphincter damage 18 27 32. There was a higher proportion of sphincter-preserving operation that had been chosen in this group (table 3).…”

“…For defining the fistula type and height, EAUS accuracy was 91% and 92%, respectively, with very good interobserver agreement 16. Diagnostic use of 3D-EAUS was comparable in both primary and recurrent FiA with ability to detect occult anal sphincter defect 32. Hydrogen peroxide (H 2 O 2 ) enhancement technique improved EAUS efficacy in identifying primary tract, internal opening and detection of secondary extension 27 33.…”

“…Regarding functional outcome, EAUS had a role in quantifying the length of muscle to be transected during surgery36 and identifying occult anal sphincter defect32 which guides the safer operative option and minimise the rate of FI 17 36. Ding et al had confirmed the favourable impact of 3D-EAUS on operative outcomes, mainly on continence function 18.…”

The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Management of Anorectal Abscess, Fistula-in-Ano, and Rectovaginal Fistula

“…52 Endoanal ultrasound, in 2 or 3 dimensions and with or without peroxide enhancement, may be useful in the management of patients with abscess or fistula, and studies demonstrate concordance between EAUS and operative findings in 73% to 100% of cases. [53][54][55] Tantiphlachiva et al 56 found that preoperative EAUS may help preserve anorectal function in patients undergoing anal fistula surgery. This study retrospectively evaluated pre-and postoperative Fecal Incontinence Severity Scores in 109 patients who underwent preoperative EAUS and in 230 patients without preoperative imaging and found significantly worse Fecal Incontinence Severity Scores in the group that did not undergo preoperative EAUS at a mean follow-up of 34 weeks.…”

Letter to the Editor: Utility of Endoanal Ultrasonography in Assessment of Primary and Recurrent Anal Fistulas and for Detection of Associated Anal Sphincter Defects

“…1 However, before adopting conclusion of the study, few questions need to be answered. First of all, anal manometry was done in patients with recurrent fistula in ano and having EAS defect in endoanal ultrasonography.…”