Three-dimensional pelvic ultrasound is a practical tool for the assessment of anal fistula

Ren, Junyi; Bai, Wenkun; Gu, Liangrui; Li, Xiao; Xue, Peng; Li, WeiMei

doi:10.1186/s12876-023-02715-5

Cited by 7 publications

(2 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…14 Recent studies have demonstrated that 3D-EAUS enables the accurate anatomical assessment of stula-in-ano, contributes to the formulation of clear and appropriate surgical treatment plans before operation, and reduces the risk of anal incontinence and recurrence. 15 Brillantino et al reported that the overall sensitivity and speci city of hydrogen peroxide-enhanced 3D-EAUS for the diagnosis of perianal sepsis were 98.3% and 91.3%, respectively. 16 Nevertheless, in many cases, both EAUS and HPUS may not detect highly restricted (suprasphincteric), subcutaneous, horseshoe-type, or small additional branching lesions.…”

Section: Discussionmentioning

confidence: 99%

Preliminary utilization of high-resolution direct MRI fistulography with hydrogen peroxide in diagnosing anorectal fistula: A retrospective study

Chang,

Qiao,

Zhang

et al. 2024

Preprint

View full text Add to dashboard Cite

Background Fistula-in-ano is an abnormal tunnel formation linking the anal canal with the perineum and perianal skin. Multiple imaging methods are available to evaluate it, among which magnetic resonance imaging (MRI) is the most advanced noninvasive preoperative method. However, it is limited in its visualization ability. Therefore, this study aimed to investigate the feasibility of using a specific mixture of 3% hydrogen peroxide (HP) and gadolinium as a direct contrast agent for high-resolution HPMRI of perianal fistula. Additionally, it investigated the value of this new method for preoperative examination of complex or recurrent fistula via a preliminary study. Methods Preoperative physical examination, conventional ultrasonography, MRI plain scan, and high-resolution direct HPMRI fistulography data from nine patients with surgically confirmed complex or recurrent fistula-in-ano were retrospectively analyzed. We also assessed the detection rates of fistula tracks and their associated internal openings, including the connection between them and the internal and external anal sphincters. Furthermore, the detection of perianal abscess was analyzed relative to the intraoperative observations. Results Surgical confirmation revealed nine cases of anal fistula, including 17 internal openings, 18 fistula tracks, 21 external openings, and six perianal abscesses. ROC curve analysis revealed that the effectiveness of the physical examination, conventional ultrasound, and MRI plain scans for detecting internal openings was lower than that of high-resolution direct HPMRI fistulography (Z = 3.739, 2.642, 2.642, all p < 0.05). The efficacy of physical examination and conventional ultrasound in detecting fistula tracks was lower than that of high-resolution direct HPMRI fistulography (Z = 2.394, 2.503, all p < 0.05). The effectiveness of physical examination in detecting perianal abscess was inferior to that of high-resolution direct HPMRI fistulography (Z = 3.417, p < 0.05). No statistically significant difference was observed in the ability of MRI plain scan to detect fistula tracks or in the capacity of conventional ultrasound to detect perianal abscesses than that of high-resolution direct HPMRI fistulography. Conclusions This novel high-resolution direct HPMRI fistulography technique enhances the visualization of recurrent and complex fistula-in-ano, enabling visualization of branched fistulas, thereby improving surgical outcomes.

show abstract

Section: Discussionmentioning

confidence: 99%

Preliminary utilization of high-resolution direct MRI fistulography with hydrogen peroxide in diagnosing anorectal fistula: A retrospective study

Chang,

Qiao,

Zhang

et al. 2024

Preprint

View full text Add to dashboard Cite

show abstract

“…TPUS assessment of perianal lesions can be appropriately improved using 3D imaging [ 7 ]. TPUS has been introduced for anal sphincter anatomy on multiple planes and high-resolution imaging of the anal canal [ 17 ]. In our study, 3D-TPUS had 95% accuracy in detecting the type of perianal fistula, which was confirmed by the surgical findings.…”

Section: Discussionmentioning

confidence: 99%

Preoperative assessment of fistula-in-ano using SonoVue enhancement during three-dimensional transperineal ultrasound

Yang,

Li,

et al. 2023

Gastroenterology Report

View full text Add to dashboard Cite

Background Accurate preoperative evaluation of fistula-in-ano can guide the choice of surgical procedure and may improve healing rates. This prospective study aimed to evaluate the accuracy of conventional 3D transperineal ultrasound (3D-TPUS) compared with SonoVue (SVE)-enhanced 3D-TPUS for the detection and classification of anal fistula. Methods In this prospective study, 3D-TPUS reconstructions were performed before and after SVE enhancement in 60 patients with fistula-in-ano who intended to undergo surgery at the Department of Anorectal Surgery, Qilu Hospital, Cheeloo College of Medicine, Shandong University (P. R. China) between January 2021 and October 2021. Accuracies of anal fistula classification, complexity classification, detection of anal fistula branches, and detection of internal opening between 3D-TPUS and SVE 3D-TPUS were compared based on a reference standard—intraoperative findings. Results This study enrolled 60 patients (mean age, 37.1 ± 11.4 years; mean follow-up, 9 ± 3 months). Intraoperative findings showed that the fistula type was intersphincteric in 23 patients (38.3%), trans-sphincteric in 35 (58.3%; 12 high and 23 low), and suprasphincteric in 2 (3.3%). Moreover, 68 internal openings were found. Compared with the accuracy of 3D-TPUS, that of SVE 3D-TPUS was similar in fistula classification [95.0% (57/60) vs 96.7% (58/60), P = 0.392], but significantly higher in internal opening evaluation [80.9% (55/68) vs 97.1% (66/68), P = 0.001], complexity classification [85.0% (51/60) vs 98.3% (59/60), P = 0.018], and detection of fistula branches [70.4% (19/27) vs 92.6% (25/27), P = 0.031]. Conclusions SVE 3D-TPUS may be a useful examination for patients with perianal fistulae because of its high accuracy and consistency with intraoperative findings, especially in complex fistula-in-ano and difficult cases.

show abstract

Comparative Evaluation Between Cutting of the Intersphincteric Space vs Cutting Seton in High Anal Fistula: A Randomized Controlled Trial

Qin,

Wu,

Zheng

et al. 2024

Journal of the American College of Surgeons

View full text Add to dashboard Cite

Background: This study compared the efficacy of cutting of the intersphincteric space (COIS) with cutting seton (CS) procedure in treating high anal fistula. Methods: Patients diagnosed with high anal fistula were allocated into groups, who randomly received COIS and CS procedures. The primary outcome was wound healing time. Secondary outcomes included surgical parameters (operation time, hospital stay, and hospitalization expense), anal sphincter function, wound pain, wound size, clinical efficacy, recurrence after 12 months of follow-up, and complications. Results: A total of 72 patients participated (36 in each group). The wound healing time was notably shorter in the COIS group than the CS group (35.75 ± 11.15 vs. 55.69 ± 13. 42 days; P< 0.001). The COIS group also demonstrated superior basic surgical parameters compared to the CS group (P< 0.001). Postoperatively, the COIS group exhibited significantly higher anal resting pressure and anal maximum contractile pressure than the CS group at 3 months postoperatively (58.39 ± 6.72 vs. 51.25 ± 4.33 mmHg; P< 0.001 and 143.72 ± 8.25 vs. 126.75 ± 11.49 mmHg; P< 0.001). The Wexner incontinence score at 3 months post-operation in the COIS group was significantly lower than in the CS group (0.50;0.00,1.00 vs. 3.00; 3.00,4.00; P< 0.001). The recurrence rate was 2.78% in the COIS group and 8.33% in the CS group without statistically difference (P= 0.607). Conclusion: In comparison to the CS procedure, COIS appears to be an effective treatment option for high anal fistulas, offering quicker wound healing time, enhanced sphincter function, less pain, minimal invasiveness, and cost-efficiency, while maintaining a high healing rate and low recurrence rate.

show abstract

Three-dimensional pelvic ultrasound is a practical tool for the assessment of anal fistula

Cited by 7 publications

References 21 publications

Preliminary utilization of high-resolution direct MRI fistulography with hydrogen peroxide in diagnosing anorectal fistula: A retrospective study

Preliminary utilization of high-resolution direct MRI fistulography with hydrogen peroxide in diagnosing anorectal fistula: A retrospective study

Preoperative assessment of fistula-in-ano using SonoVue enhancement during three-dimensional transperineal ultrasound

Comparative Evaluation Between Cutting of the Intersphincteric Space vs Cutting Seton in High Anal Fistula: A Randomized Controlled Trial

Contact Info

Product

Resources

About