Different characteristics of high and low transsphincteric fistulae

Onkelen, Robbert S. van; Gosselink, M.; Rosmalen, Joost van; Thijsse, Sjoerd; Schouten, W. R.

doi:10.1111/codi.12578

Cited by 16 publications

(8 citation statements)

References 18 publications

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“…The treatment of simple fistula is usually based on fistulotomy, which provides healing for about 90% of patients and a low risk of incontinence (3). The main problem lies in the management of complex fistula, as fistulotomy represents an unacceptable risk of incontinence in these patients.…”

Section: Discussionmentioning

confidence: 99%

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Using autologous platelet-rich plasma for the treatment of complex fistulas

Moreno-Serrano¹,

García-Díaz²,

Ferrer-Márquez³

et al. 2016

Rev Esp Enferm Dig

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Objective:This study aims to demonstrate the effectiveness and safety of autologous fibrin gel rich in platelet growth factors for the treatment of complex perianal fistulas.Material and methods: Prospective epidemiological study. Patients with complex perianal fistula or perianal fistula mere alteration of continence are included. identification of both holes and the journey, curettage of it and instillation of Vivostat PRF ® in the way it is done to observe excess material by OFE. The variables analyzed were: age, sex, use of prior Seton clinic prevalent type of fistula, postoperative complications, fistula closure and impaired quality of life using the SF-36 test (v2).Results: From January 2011 to May 2013 have involved 23 patients, 12 men and 11 women, with an average age of 49 years and a minimum follow-up of 12 months. Two dropped out. 17 patients had low transsphincteric fistulas, 2 and 2 high transsphincteric intersphincteric with impaired continence. The most common symptom is the discharge. Twelve patients had a loose seton (62%), of which nine cured. Of all the patients we have operated the success rate is 62%. No patient developed incontinence after treatment. Only two reported a worse quality of life after surgery.Conclusion: This study demonstrates that there is a clear benefit to the use of Vivostat PRF ® as a treatment for complex perianal fistulas. It is a highly reproducible technique with acceptable results and does not produce impairment of continence.

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Section: Discussionmentioning

confidence: 99%

“…Fistulotomy is the most likely method to result in cure for simple fistula, reaching 90% of success with low risk for incontinence (3). These results are also offered by fistulectomy, but at the expense of a higher risk of sphincteric fiber injury and therefore increased risk for incontinence.…”

Section: Introductionmentioning

confidence: 99%

Using autologous platelet-rich plasma for the treatment of complex fistulas

Moreno-Serrano¹,

García-Díaz²,

Ferrer-Márquez³

et al. 2016

Rev Esp Enferm Dig

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“…There are also epidemiological data that do not support the cryptoglandular theory. The higher incidence of the internal opening at the posterior quadrant of the anorectum is difficult to explain if the anal glands are equally circumferentially distributed . Probably, some of these fistulae originate from a dorsal anal fissure.…”

mentioning

confidence: 99%

The cryptoglandular theory revisited

2015

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“…Simple fistula is treated usually by fistulotomy, that provides healing for about 90% of patients with low risk of incontinence. 6 The main problem lies in the treatment of complex perianal fistula, as fistulotomy represents an unacceptable risk of incontinence in these patients. 7 Platelet α-granules contain mitogenic and chemotactic growth factors (GF) and associated healing molecules in an inactive form, important in wound healing, such as platelet-derived growth factor (PDGF), transforming growth factors β1, β2, β3, platelet-derived angiogenesis factor, insulin-like growth factor 1, platelet factor 4 (PF-4), epidermal growth factor, epithelial cell grow factor, vascular endothelial cell growth factor (VEGF), basic fibroblast growth factor and others cytokines.…”

Section: Discussion:-mentioning

confidence: 99%

Effectiveness of Autologous Platelet Rich Plasma in the Treatment of Hight Perianal Fistula.

Orban¹,

Goda²

2019

IJAR

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high perianal fistula, platelet rich plasma. Background: The main issue involves high perianal fistula management, as fistulotomy would represent an inacceptable risk of incontinence in such patients. Platelet rich plasma (PRP) is defined as a portion of patient own plasma with high concentration platelet and growth factor levels as obtained by centrifugation. Platelets have alpha granules that contain several proteins with multiple actions on the various aspects of tissue repair. Aim of the study was to evaluate the use of autologous platelet rich plasma in the treatment of perianal fistula. Methods: A prospective study including patients with high perianal fistula who presented to General Surgery Department of Zagazig University in the period from September 2016 to February 2019. Result: We had 16 patients with a diagnosis of high perianal fistula, 9 males and 7 females. We had a clinical success rate of 75% (12 patients out of 16 were completely healed with no recurrence throughout the follow up period). Two patients (12.5%) developed postoperative abscess formation and another two patients (12.5%) showed persistent external opening. Conclusion: Platelet rich plasma is promising in the treatment of high perianal fistula without affection of fecal continence.

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Different characteristics of high and low transsphincteric fistulae

Cited by 16 publications

References 18 publications

Using autologous platelet-rich plasma for the treatment of complex fistulas

Using autologous platelet-rich plasma for the treatment of complex fistulas

The cryptoglandular theory revisited

Effectiveness of Autologous Platelet Rich Plasma in the Treatment of Hight Perianal Fistula.

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