Lift procedure for long complex ano-scrotal fistula and review of literature

kumar, T Siva; Naresh, G; Akther, Md. Jawed

doi:10.18203/2349-2902.isj20164484

Cited by 3 publications

(3 citation statements)

References 8 publications

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“…The presentations are variable in those cases. The scrotum usually presents with redness, swelling, pain, and pus discharge from the external opening, while anal symptoms may be absent or minimal [4][5][6]. Such presentations may be confusing with acute scrotal diseases.…”

Section: Introductionmentioning

confidence: 99%

Preoperative magnetic resonance imaging of anal fistulas with scrotal extension

Nguyen

et al. 2023

Preprint

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The aim of this study was to elucidate the magnetic resonance (MR) characteristics of anal fistulas extending to the scrotum, the rules applicable to them, and to correlate MR features with surgical findings. We conducted a retrospective study in 150 consecutive patients with anal fistulas extending into the scrotum, who were diagnosed and underwent surgery at University Medical Center Ho Chi Minh City between January 2017 and April 2022. MR findings were evaluated and compared with surgical findings using the Cohen’s kappa coefficient (k) with a 95% confidence interval. 150 patients (mean age 37.6 ± 10.9 years) with 166 fistulas, including 150 anal fistulas with scrotal extension. Most fistulas were low transsphincteric (80.0%, 120/150 patients). There was strong agreement for primary tract classification and detecting the location of internal openings between MRI and surgical findings with k = 0.83 (0.78–0.87) and k = 0.89 (0.85 – 0.93) (p<0.001), respectively. There is a significant correlation between the location of internal openings and the type of fistula (p<0.05). Low transsphincteric fistulas were predominant in the anterior group (103/122 patients vs. 10/19 patients), while in the posterior group it was more common in the high transsphincteric fistulas (7/19 patients vs. 14/122 patients), and the intersphincteric fistulas (1/19 patients vs. 5/122 patients); and the suprasphincteric fistulas were only seen in posterior group (1 patient). Anal fistulas with scrotal extension are exceptions to Goodsall’s rule. Albeit being long-tract fistulas, most of them are low transsphincteric and have anterior internal openings.

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Section: Introductionmentioning

confidence: 99%

Preoperative magnetic resonance imaging of anal fistulas with scrotal extension

Nguyen

et al. 2023

Preprint

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“…Perianal fistula represents a chronic stage of infection in the anorectal region and is characterized by persistent discharge of pus or recurring pain due to abscess formation, followed by periodic spontaneous drainage [3] . Various classifications have been proposed to categorize these fistulas based on their location [low or high], complexity [simple or complex], or anatomical characteristics [inter-sphincteric, trans-sphincteric, suprasphincteric, or extrasphincteric] [4] .…”

Section: Introductionmentioning

confidence: 99%

Role of Fibrin Glue versus Fistulotomy in Treatment of High Fistula-In-Ano

Mohamed,

Sayouh,

Soliman

2023

International Journal of Medical Arts

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Article informationBackground: Perianal fistula is a frequent surgical condition that affect patient's daily activity, causing chronic pain and discomfort. High-type fistula-in-ano is especially hard to manage due to its position. Standard surgical methods are associated with many adverse events such as incontinence and repeated infections. Fibrin glue is a kind of biological glue which facilitates tract obliteration, with preservation of anal sphincter. Aim of the work:This study aims at comparing the efficacy of fibrin glue versus fistulotomy in the treatment of high perianal fistulas. Patients and Methods: In the present study, 30 patients diagnosed with a high-type perianal fistula were divided into two groups; group [1] undergone standard fistulotomy, and group [2] undergone fibrin glue. Operative outcomes, post-operative improvements and complications were compared. Results: Patients in group [2] had significant short operative time [31.1 ± 12.5 min. in group 1 vs. 19.7 ± 1.62 min. in group 2; P, 0.004]. Group 2 had a significantly shorter hospital stay length than group 1 [1.93 ± 0.79 days for group 1 and 1.31 ± 0.35 days for group 2; P, < 0.001]. No significant difference was shown between studied groups regarding pain improvement, wound infection, wound discharge and incontinence at one week following surgery. However, group 1 patients had a significant [P, <0.001] less healing time than group 2. At six months following surgery, patients in group 1 reported higher rate of infection [four patients vs. none in group 2; P, 0.03] and higher recurrence rate [six in group 1 vs. one patient in group 2; P, 0.03]. Conclusion:The use of fibrin glue injection is a viable, valuable, and effective alternative for treating fistula-in-ano. It is associated with lower complications and less recurrence, although it had longer time for complete healing.

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“…The presentations are variable in those cases. The scrotum usually presents with redness, swelling, pain, and pus discharge from the external opening, while anal symptoms may be absent or minimal (4)(5)(6). Such presentations may be confusing with acute scrotal diseases such as infection, abscess of the scrotum, testis, or urethral diverticulum, or even malignancy.…”

Section: Introductionmentioning

confidence: 99%

Preoperative magnetic resonance imaging of anal fistulas with scrotal extension: a retrospective study

Nguyen

et al. 2023

Front. Surg.

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IntroductionThis study aimed to elucidate the magnetic resonance (MR) characteristics of anal fistulas extending to the scrotum, and the applicable rules, and to correlate MR features with surgical findings.MethodsWe conducted a retrospective study in 150 consecutive patients with anal fistulas extending into the scrotum, who were diagnosed and underwent surgery at University Medical Center Ho Chi Minh City between January 2017 and April 2022. MR findings were evaluated and compared with surgical findings using Cohens kappa coefficient (k) with a 95% confidence interval.Results150 patients (mean age 37.6 ± 10.9 years) with 166 fistulas, including 150 anal fistulas with scrotal extension. Most fistulas were low transsphincteric (80.0%, 120/150 patients). There was a strong agreement for primary tract classification and detecting the location of internal openings between MRI and surgical findings with k = 0.83 (0.780.87) and k = 0.89 (0.85 0.93) (p<0.001), respectively. There is a significant correlation between the location of internal openings and the type of fistula (p<0.05). Low transsphincteric fistulas were predominant in the anterior group (103/122 patients vs. 10/19 patients), while in the posterior group, it was more common in the high transsphincteric fistulas (7/19 patients vs. 14/122 patients), and the intersphincteric fistulas (1/19 patients vs. 5/122 patients); and the suprasphincteric fistulas were only seen in the posterior group (1 patient).ConclusionAnal fistulas with scrotal extension are exceptions to Goodsalls rule. Albeit long-tract fistulas, most are low transsphincteric and have anterior internal openings.

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Lift procedure for long complex ano-scrotal fistula and review of literature

Cited by 3 publications

References 8 publications

Preoperative magnetic resonance imaging of anal fistulas with scrotal extension

Preoperative magnetic resonance imaging of anal fistulas with scrotal extension

Role of Fibrin Glue versus Fistulotomy in Treatment of High Fistula-In-Ano

Preoperative magnetic resonance imaging of anal fistulas with scrotal extension: a retrospective study

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