Study on the pathogenesis of ischiorectal abscess and fistula viewed from the standpoint of transanal ultrasonic examination.

Tsuji, Y.; Fujiyoshi, T.; Takagi, Koichi; Fujiyoshi, Yusuke; Kawano, Masaki; Hashimoto, M; Hamada, Akira; Fujimoto, N.; Sasaki, Tatsuya; Takano, Masahiro

doi:10.3862/jcoloproctology.44.146

Cited by 3 publications

(5 citation statements)

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“…In addition, due to the raised abscess pressure, the lesion may extend into the ischiorectal fossa, resulting in the development of an anal fistula [8]. Tsuji et al (1991) had similar findings [9], but the difference seems to be due to the difference in the observed cases, as explained at the beginning of this section. A detailed analysis of the progression of the disease is difficult unless the abscess is in the acute stage.…”

Section: ．The Pathogenesis Of Ischiorectal Fistulasmentioning

confidence: 91%

“…An analysis of 57 cases of ischiorectal lesions (36 abscesses and 21 fistulas) was conducted using anal ultrasound in 1991, and the progression of the ischiorectal abscesses and fistulas was reported [9]. In general, the developmental pattern of an ischiorectal fistula is clear at the time of abscess, but when the lesion progresses into a fistula, the lesion is resorbed and shrinks, which makes a detailed analysis difficult.…”

Section: ．The Pathogenesis Of Ischiorectal Fistulasmentioning

confidence: 99%

“…The abscess then gradually resorbs, resulting in a unilateral or horseshoe-shaped ischiorectal fistula. The intermediate abscess described above also shrinks posteriorly to form an ischiorectal fistula as well [9]. Kurihara et al (2006) reported on the surgical findings of 320 cases of posterior deep complex fistulas, 30 cases of preoperative magnetic resonance imaging (MRI), and 2 cases of cadaver dissections.…”

Section: ．The Pathogenesis Of Ischiorectal Fistulasmentioning

confidence: 99%

“…It is useful in identifying the presence or absence of an anal fistula, the type and course of the fistula, the location of the PO, the connection of the fistula to the sphincter, and the differential diagnosis of the ischiorectal lesions (Figure 5) [12]. There are various kinds of ischiorectal fistulas, such as fistulas existing only in the Courtney's space, running from the posterior region to the external sphincter in the ischiorectal fossa on one side or on both sides in the shape of a horseshoe [9]. The accuracy rate for the detection of ischiorectal fistulas using anal ultrasound has been reported to be about 89.5% [13].…”

Section: )Digital Examinationmentioning

confidence: 99%

“…The incision is made from outside the superficial external sphincter; this method is now known as the sphincter-preserving procedure. This procedure was designed based on an observation using anal ultrasound for ischiorectal fistula as described by Tsuji in 1991 [9]. This procedure is specifically designed to be performed from the lateral side of the superficial external sphincter.…”

Section: )Development Of the Partial Sphincter-preserving Proceduresmentioning

confidence: 99%

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A Retrospective Critique of the Various Sphincter-preserving Surgical Procedures for Ischiorectal Fistula

Tsuji

Takano

Yamada

et al. 2022

J Anus Rectum Colon

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In the 1950s, the cause of anal fistulas was identified as an infection of the anal gland (cryptoglandular infection theory). Thereafter, treatment for this disorder began in the 1960s with the lay-open procedure, which involved incising the sphincter and the fistula tract. However, it was found that too much invasion into the sphincter could result in postoperative fecal incontinence. Thus, to reduce such risk, sphincterpreserving surgery was applied for superficial anal fistula in 1961 and for deep anal fistula (ischiorectal fistula) in 1965. Over the years, more effective sphincter-preserving procedures for ischiorectal fistula have been developed to improve the quality of life of the patient. In this review article, we aim to first introduce the basic surgical techniques for ischiorectal fistula. We will discuss the anatomy of the anus and the pathogenesis of ischiorectal fistula and will provide some diagnostic methods. Representative sphincterpreserving procedures that have been performed for ischiorectal fistula since 1965 will also be categorized and outlined chronologically. The discussion will look at the following techniques for ischiorectal fistula and outline the advantages and disadvantages of each procedure so that they can be used as a reference for ischiorectal fistula surgery in the future: the lay-open procedure (fistulotomy and fistulectomy), the Hanley procedure (first partial sphincter-preserving procedure), the muscle-filling procedure, the Moriya method and Ui method (modified partial sphincter-preserving procedure), the Takano method and the sphincterpreserving lateral procedure (complete sphincter-preserving procedure), the seton method (a cross between the lay-open procedure and sphincter-preserving procedure), and the overseas sphincter-preserving procedure.

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Section: ．The Pathogenesis Of Ischiorectal Fistulasmentioning

confidence: 91%

Section: ．The Pathogenesis Of Ischiorectal Fistulasmentioning

confidence: 99%

Section: ．The Pathogenesis Of Ischiorectal Fistulasmentioning

confidence: 99%