Prognostic Value of Endoanal Ultrasound for Fistula-in-Ano: A Retrospective Analysis

Abstract

The findings and accuracy of preoperative endoanal ultrasound did not influence postoperative outcome.

Impact of three‐dimensional endoanal ultrasound on the outcome of anal fistula surgery: a prospective cohort study

“…The accuracy rate of EAUS is estimated as 80%-89% for delineating fistula tract, 91% for internal opening. EAUS is particularly accurate in identifying horseshoe abscess and its extension [5,[15][16][17][18]. Threedimensional ultrasound techniques provide even better imaging quality and orientation, with an accuracy rate comparable to that of MRI, especially for complex anal fistula [12,13,19,20].…”

“…In addition, there is a financial cost of the EAUS examination and discomfort experienced by some patients, especially when hydrogen peroxide injection is performed [7,23]. Therefore, the clinical utility of preoperative EAUS has been questioned [5,6]. In contrast Ratto et al [18] reported that preoperative EAUS led to a high rate of operative success as well as a low frequency of anal incontinence, suggesting that the use of EAUS improves postoperative outcomes.…”

“…However, it remains unclear whether the accurate preoperative EAUS can translate into better outcomes for anal fistula surgery. There are studies that demonstrate that the postoperative fistula recurrence rate is not influenced by the use of EAUS [5,6]. The data are limited and conflicting and there are no published prospective studies on this topic [5][6][7].…”

“…There are studies that demonstrate that the postoperative fistula recurrence rate is not influenced by the use of EAUS [5,6]. The data are limited and conflicting and there are no published prospective studies on this topic [5][6][7]. In routine practice in China, the vast majority of patients with anal fistulae are evaluated by EUA only.…”

S3 guidelines: cryptoglandular anal fistulas

“…Die Korrelation zwischen endoanalem Ultraschall und der intraoperativen klinischen Untersuchung liegt bei über 90% [37,155,167,218]. Eine Beeinflussung des operativen Vorgehens in erster Linie im Sinne eines mehr konservativen Vorgehens wird von Lindsey et al [159] bei 38% der Patienten beschrieben, während Weisman et al [299] keine Beeinflussung des perioperativen Verlaufes durch die Endosonographie nachweisen konnten. Subasighe et al [262] sehen die Bedeutung der Endosonographie v. a. im Nachweis von nichtdrainierten Sekretverhalten vor einer Fisteloperation.…”