Is the Outcome of Transanal Advancement Flap Repair Affected by the Complexity of High Transsphincteric Fistulas?

Mitalas, Litza E.; Dwarkasing, Roy S.; Verhaaren, Rob; Zimmerman, D. D. E.; Schouten, W. R.

doi:10.1007/dcr.0b013e31820eee2e

Cited by 24 publications

(13 citation statements)

References 13 publications

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“…The success rate of fibrin glue was 14-63% [16,17]. The cure rate of Mucosa advancement flap was 66-87% but the recurrence rate was high [18][19][20]. And mild to moderate incontinence occurred in 35% of the patients after operation.…”

Section: Discussionmentioning

confidence: 96%

Autologous adipose-derived stem cells for the treatment of Crohn’s fistula-in-ano: an open-label, controlled trial

Zhou

Zhang

et al. 2020

Stem Cell Res Ther

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Background: Crohn's fistula-in-ano is a refractory disease in colorectal and anal surgery. Although autologous adiposederived stem cell (ADSC) has been used in the treatment of Crohn's fistula-in-ano because of its convenience, nonincision of normal tissue, good tolerance, repeatability, quick recovery, less pain, less damage to anal function, and high quality of life during the perioperative period, there are no reports of its use in China. This is the first clinical trial in China on the treatment of Crohn's fistula-in-ano with ADSC to evaluate its efficacy and safety. Methods: A total of 22 patients with Crohn's fistula-in-ano were enrolled in this study from January 2018 to October 2018 in the

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Section: Discussionmentioning

confidence: 96%

Autologous adipose-derived stem cells for the treatment of Crohn’s fistula-in-ano: an open-label, controlled trial

Zhou

Zhang

et al. 2020

Stem Cell Res Ther

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“…Although advances in surgery and technology have led to various ''minimally invasive'' approaches [1,2], results in terms of success rate and recurrence are quite disappointing. The failure rate is approximately 30-60 % for established surgical procedures such as the endorectal advancement flap (ERAF) [3,4] and injection of biological glues [5,6]. Also the initial enthusiasm for even newer techniques, such as anal fistula plug [7,8] and ligation of the intersphincteric fistula tract (LIFT) [9,10], decreased at the long-term follow-up, with a recurrence rate of about 70-80 % and 30-60 %, respectively [11][12][13][14][15].…”

Section: Introductionmentioning

confidence: 99%

Fistulotomy or fistulectomy and primary sphincteroplasty for anal fistula (FIPS): a systematic review

et al. 2015

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There is still no clear consensus about surgical treatment of anal fistulas. Fistulotomy or fistulectomy and primary sphincter reconstruction is still regarded with skepticism. The aim of this systematic review was to evaluate the evidence in the literature supporting the use of this technique in the treatment of complex anal fistulas. MEDLINE, EMBASE and Cochrane Library databases were searched for the period between 1985 and 2015. The studies selected were peer-reviewed articles, with no limitations concerning the study cohort size, length of the follow-up or language. Technical notes, commentaries, letters and meeting abstracts were excluded. The major endpoints were the technique adopted, clinical efficacy, changes at anorectal manometry and assessment of quality of life after the procedure. Fourteen reports (666 patients) satisfied the inclusion criteria. The quality of the studies was low. Some differences about the surgical technique emerged; however, after a weighted average duration of follow-up of 28.9 months, the overall success rate was 93.2 %, with a low morbidity rate. The overall postoperative worsening continence rate was 12.4 % (mainly post-defecation soiling). In almost all cases, the anorectal manometry parameters remained unchanged. The quality of life, when evaluated, improved significantly. Fistulotomy or fistulectomy and primary sphincteroplasty could be a therapeutic option for complex anal fistula. Success rates were very high and the risk of postoperative fecal incontinence was lower than after simple fistulotomy. Well-designed trials are needed to support the inclusion of this technique in a treatment algorithm for the management of complex anal fistulas.

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“…In a previous study, examining the complexity of high transsphincteric fistulae, we observed associated abscesses in 36% of patients. Abscesses occurred more frequently in patients with an internal opening located posteriorly than anteriorly (47% vs 5%) . In the present study, the incidence of associated abscesses was 54% in patients with a high transsphincteric fistula and 4% in those with a low transsphincteric fistula.…”

Section: Discussionmentioning

confidence: 46%

Different characteristics of high and low transsphincteric fistulae

et al. 2014

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Is the Outcome of Transanal Advancement Flap Repair Affected by the Complexity of High Transsphincteric Fistulas?

Abstract: The complexity of high transsphincteric fistulas does not affect the outcome of transanal advancement flap repair.

Cited by 24 publications

References 13 publications

Autologous adipose-derived stem cells for the treatment of Crohn’s fistula-in-ano: an open-label, controlled trial

Autologous adipose-derived stem cells for the treatment of Crohn’s fistula-in-ano: an open-label, controlled trial

Fistulotomy or fistulectomy and primary sphincteroplasty for anal fistula (FIPS): a systematic review

Different characteristics of high and low transsphincteric fistulae

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