Open coring-out (function-preserving) technique for low fistulas

Abstract

This technique, which is continually being improved and evaluated, is simple, has a low risk of infection, preserves functions, and prevents deformity of the anal verge and perineum.

Anal Fistulotomy with Radiofrequency

“…While considering factors like interference with continence, wound complications and recurrence, the results with radiofrequency fistulotomy are comparable with other treatment techniques of anal fistula [4], namely marsupialization [5], sphincter-preserving procedures [6], coring-out technique [7], instillation of fibrin glue [8], using seton [9], and conventional fistulotomy [10]. Our study suggests that radiofrequency can be used as an alternative to conventional procedures for anal fistula.…”

“…This is comparable to or even better than conventional treatment techniques like using fibrin glue [8] (105 days), conventional fistulotomy [10] (70 days), seton [9] (63 days), and marsupialization [10] (42 days). Even the open coring-out [7] (function-preserving) technique is fraught with the problem of delayed wound healing.…”

Radiofrequency fistulotomy: a better alternative for treating low anal fistula

“…In comparison with other treatment techniques for anal fistula, our study produced results that were equal to or even better than obtained using these others, such as marsupialization, 6,7 sphincter preserving procedures, 8 coring-out technique, 9 instillation of fibrin glue, [10][11][12] flap procedures, 13,14 excision of fistula and closure of internal opening, 15 incision, and lay-open 16 using rubber seton 17 or medicated seton. 18 The improvement came in terms of wound healing, wound complications, interference with continence and recurrence (Table 1).…”

Simple fistula-in-ano: is it all simple? A systematic review

“…Among the included studies, 28 were prospective studies [21-25, 29, 38-40, 42, 44, 48, 51, 53, 56, 58-62, 64, 65, 68, 70, 71, 74-76], 19 were retrospective series [2, 8, 13-15, 18, 26-28, 33, 43, 45, 57, 63, 66, 67, 69, 72, 73], and 19 were randomized clinical trials (RCT) [16, 17, 19, 20, 30-32, 34-37, 41, 46, 47, 49, 50, 52, 54, 55] (Tables 1-2). The quality of the studies was generally low with a consistent risk of bias; the median score of the Jadad Scale for RCT was 3 (1-5), and only 2 studies had the highest possible score [52,55]; the median MINORS score for non-comparative studies was 12 (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16), with only one study that could be regarded as excellent [44], while the median MINORS score for comparative studies was 17 (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21) (Tables 1, 2). Risk of bias of the selected studies could be attributed mainly to a retrospective design, difficulty or impossibility of patients' and operators' blinding, small sample size, short follow-up, heterogeneity of the analyzed variables, absence of uniform definition of the main outcomes (success rate, continence impairment).…”