scholarly journals Video-assisted anal fistula treatment versus fistulectomy and sphincter repair in the treatment of high cryptoglandular anal fistula: a randomized clinical study

BJS Open ◽  
2021 ◽  
Vol 5 (5) ◽  
Author(s):  
Karam M Sørensen ◽  
Sören Möller ◽  
Niels Qvist
Keyword(s):  
Quality Of Life ◽  
Recurrence Rate ◽  
Anal Fistula ◽  
Anal Manometry ◽  
Single Centre ◽  
Recurrence Rates ◽  
Wexner Score ◽  
Faecal Continence ◽  
Fistula Treatment

Abstract Background Video-assisted anal fistula treatment (VAAFT) may have a recurrence rate comparable to that of fistulectomy and sphincter repair (FSR) in the treatment of high anal fistula and with potential advantages in wound healing, functional outcome and quality of life. The aim and objectives of the study are to compare the outcome of VAAFT with that of FSR for high cryptoglandular anal fistula. Methods This was a single-centre randomized controlled trial of adults with high anal fistula comparing FSR with VAAFT. Primary outcome was fistula recurrence. Secondary outcomes were results of anal manometry, quality of life and faecal continence. A power calculation of 33 patients in each arm (1 : 1) was based on recurrence in the FSR and VAAFT groups of 5 per cent and 30 per cent respectively. Follow-up at 6 months after surgery included physical examination, MRI, anal manometry, quality-of-life assessment (RAND SF 36 questionnaire) and faecal-continence assessment (Wexner score). Results The study was terminated early due to high recurrence rates in both groups. A total of 45 patients were included. Recurrence rates were 65 per cent for VAAFT and 27 per cent for FSR, with hazard ratio 4.18 (P = 0.016). Length of the fistula was a risk factor with an association with recurrence (hazard ratio 1.8, P = 0.020). There were significant differences in quality of life in favour of FSR and in anal manometry in favour of VAAFT with a significant improvement in Wexner score in both groups. Conclusion FSR was associated with a lower recurrence rate than VAAFT in the management of complex anal fistulae in this single-centre study but the study was terminated early due to higher than predicted recurrence rate in both groups. Registration number NCT02585167 (http://www.clinicaltrials.org).

Management and Outcomes of Colovesical Fistula Repair

2012 ◽  
Vol 78 (5) ◽  
pp. 514-518 ◽  
Author(s):  
Elizabeth T. Lynn ◽  
Nalin E. Ranasinghe ◽  
Kai B. Dallas ◽  
Celia M. Divino
Keyword(s):  
Quality Of Life ◽  
Patient Satisfaction ◽  
Postoperative Complications ◽  
Recurrence Rate ◽  
Recurrence Risk ◽  
Fistula Repair ◽  
Colovesical Fistula ◽  
Recurrence Rates ◽  
Patient Satisfaction Score

This large retrospective study presents the largest colovesical fistula (CVF) series to date. We report on recurrence risk factors and patient satisfaction based on quality of life after CVF repair. Approval was obtained from The Mount Sinai School of Medicine Institutional Review Board, and a retrospective review was performed from 2003 to 2010 involving 72 consecutive patients who underwent a colovesical fistula repair. The CVF recurrence rate was 11 per cent. Ten percent of our patients who had a history of radiation therapy were at a significantly higher risk of developing a recurrence. Noted recurrence rates were significantly higher in advanced bladder repairs compared with simple repair ( P = 0.022). The modified (Gastrointestinal Quality of Life Index) surveys showed overall patient satisfaction score was 3.6, out of a maximum score of 4, regardless of the type of repair or any postoperative complications. Our study found the CVF recurrence rate to be 11 per cent. Patients at higher risk of recurrence include those needing advanced bladder repair, those with “complex” CVF, and those whose fistulas involve the urethra. Patient satisfaction was found to be more closely linked to the resolution of CVF symptoms, irrespective of the type of repair performed or development of postoperative complications.

Quality of life of patients after surgical treatment of anal fistula; the role of anal manometry

2001 ◽  
Vol 3 (6) ◽  
pp. 417-421 ◽  
Author(s):  
E. Mylonakis ◽  
C. Katsios ◽  
D. Godevenos ◽  
B. Nousias ◽  
A. M. Kappas
Keyword(s):  
Quality Of Life ◽  
Surgical Treatment ◽  
Anal Fistula ◽  
Anal Manometry

scholarly journals Quality of life with anal fistula

2016 ◽  
Vol 98 (5) ◽  
pp. 334-338 ◽  
Author(s):  
HA Owen ◽  
GN Buchanan ◽  
A Schizas ◽  
R Cohen ◽  
AB Williams
Keyword(s):  
Quality Of Life ◽  
Anal Fistula ◽  
Recurrent Disease ◽  
Short Form ◽  
Factors Affecting ◽  
Incontinence Score ◽  
Sf 36 ◽  
Working Age ◽  
Faecal Continence

Introduction Anal fistula affects people of working age. Symptoms include abscess, pain, discharge of pus and blood. Treatment of this benign disease can affect faecal continence, which may, in turn, impair quality of life (QOL). We assessed the QOL of patients with cryptoglandular anal fistula. Methods Newly referred patients with anal fistula completed the St Mark’s Incontinence Score, which ranges from 0 (perfect continence) to 24 (totally incontinent), and Short form 36 (SF–36) questionnaire at two institutions with an interest in anal fistula. The data were examined to identify factors affecting QOL. Results Data were available for 146 patients (47 women), with a median age of 44 years (range 18–82 years) and a median continence score of 0 (range 0–23). Versus population norms, patients had an overall reduction in QOL. While those with recurrent disease had no difference on continence scores, QOL was worse on two of eight SF–36 domains (p<0.05). Patients with secondary extensions had reduced QOL in two domains (p<0.05), while urgency was associated with reduced QOL on five domains (p<0.05). Patients with loose seton had the same QOL as those without seton. No difference in urgency was found between patients with and without loose seton. In primary fistula patients, 19.4% of patients experienced urgency versus 36.3% of those with recurrent fistulas. Conclusions Patients with anal fistula had a reduced QOL, which was worse in those with recurrent disease, secondary extensions and urgency. Loose seton had no impact on QOL.

Different Types of Auricular Keloids and Treatment by Intralesional Cryosurgery: Best Practice for Obtaining Long-Lasting Clinical Results

Dermatology ◽  
2021 ◽  
pp. 1-10
Author(s):  
Yaron Har-Shai ◽  
Lior Har-Shai ◽  
Viktor A. Zouboulis ◽  
Christos C. Zouboulis
Keyword(s):  
Quality Of Life ◽  
Body Image ◽  
Recurrence Rate ◽  
Best Practice ◽  
Clinical Results ◽  
Psychosocial Impact ◽  
Aesthetic Outcome ◽  
The Past ◽  
Different Types

<b><i>Background:</i></b> Auricular keloids belong to the most perplexing medical conditions, which have significant psychosocial impact on the patient’s body image and quality of life. <b><i>Summary:</i></b> The article is purposed to provide dermatologists and plastic surgeons with the best proven practice using intralesional cryosurgery for the treatment of the different auricular keloid types in order to obtain superior clinical results by minimizing the probability of recurrence. In the past 20 years, the authors have developed novel procedures in order to increase the effectiveness of intralesional cryosurgery on auricular keloids, including hydrodissection, warm gauze technique, and excision of dangling skin. Long-lasting clinical results with a low recurrence rate and a satisfactory aesthetic outcome are achieved with no deformation of the ear framework.

scholarly journals Slowly resorbable biosynthetic mesh: 2-year results in VHWG grade 3 hernia repair

Hernia ◽  
2021 ◽  
Author(s):  
M. M. J. Van Rooijen ◽  
T. Tollens ◽  
L. N. Jørgensen ◽  
T. S. de Vries Reilingh ◽  
G. Piessen ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Hernia Repair ◽  
Hernia Recurrence ◽  
Recurrence Rates ◽  
Elective Repair ◽  
Significant Difference ◽  
Grade 3

Abstract Introduction Information on the long-term performance of biosynthetic meshes is scarce. This study analyses the performance of biosynthetic mesh (Phasix™) over 24 months. Methods A prospective, international European multi-center trial is described. Adult patients with a Ventral Hernia Working Group (VHWG) grade 3 incisional hernia larger than 10 cm2, scheduled for elective repair, were included. Biosynthetic mesh was placed in sublay position. Short-term outcomes included 3-month surgical site occurrences (SSO), and long-term outcomes comprised hernia recurrence, reoperation, and quality of life assessments until 24 months. Results Eighty-four patients were treated with biosynthetic mesh. Twenty-two patients (26.2%) developed 34 SSOs, of which 32 occurred within 3 months (primary endpoint). Eight patients (11.0%) developed a hernia recurrence. In 13 patients (15.5%), 14 reoperations took place, of which 6 were performed for hernia recurrence (42.9%), 3 for mesh infection (21.4%), and in 7 of which the mesh was explanted (50%). Compared to baseline, quality of life outcomes showed no significant difference after 24 months. Despite theoretical resorption, 10.7% of patients reported presence of mesh sensation in daily life 24 months after surgery. Conclusion After 2 years of follow-up, hernia repair with biosynthetic mesh shows manageable SSO rates and favorable recurrence rates in VHWG grade 3 patients. No statistically significant improvement in quality of life or reduction of pain was observed. Few patients report lasting presence of mesh sensation. Results of biosynthetic mesh after longer periods of follow-up on recurrences and remodeling will provide further valuable information to make clear recommendations. Trial registration Registered on clinicaltrials.gov (NCT02720042), March 25, 2016.

scholarly journals Adjuvant Radiotherapy after Surgical Excision in Keloids

Medicina ◽  
2021 ◽  
Vol 57 (7) ◽  
pp. 730
Author(s):  
Jeong Won Lee ◽  
Ki Ho Seol
Keyword(s):  
Quality Of Life ◽  
Side Effects ◽  
Adjuvant Therapy ◽  
Local Control ◽  
Adjuvant Radiotherapy ◽  
Surgical Excision ◽  
Recurrence Rates ◽  
High Tendency ◽  
Advantages And Disadvantages

Keloids are a benign fibroproliferative disease with a high tendency of recurrence. Keloids cause functional impairment, disfigurement, pruritus, and low quality of life. Many therapeutic options have been used for keloids. However, the high recurrence rates have led to the use of adjuvant therapy after surgical keloid excision. There are different radiotherapy regimens available, and the advantages and disadvantages of each are still unclear. The aim of this review is to explain the appropriate radiotherapy regimen for keloids as well as discuss the recent reports on keloid management with radiotherapy. Adjuvant radiotherapy after surgical excision for keloids yields excellent local control with tolerable side effects. Hypofractionated radiotherapy with a BED of more than 28 Gy (α/β value of 10) after excision is recommended in the light of its biologic background.

Quality of life two years after severe trauma: A single centre evaluation

Injury ◽  
2014 ◽  
Vol 45 ◽  
pp. S100-S105 ◽  
Author(s):  
Sigune Kaske ◽  
Rolf Lefering ◽  
Heiko Trentzsch ◽  
Arne Driessen ◽  
Bertil Bouillon ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Severe Trauma ◽  
Single Centre

scholarly journals Design and Psychometric Evaluation of the Quality of Life in Patients With Anal Fistula Questionnaire

2017 ◽  
Vol 60 (10) ◽  
pp. 1083-1091 ◽  
Author(s):  
Manuel Ferrer-Márquez ◽  
Natalia Espínola-Cortés ◽  
Angel Reina-Duarte ◽  
José Granero-Molina ◽  
Cayetano Fernández-Sola ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Anal Fistula ◽  
Psychometric Evaluation

scholarly journals The Current Status of Integrative Oncology in Korea

2021 ◽  
Vol 20 ◽  
pp. 153473542110638
Author(s):  
Eun-Bin Kwag ◽  
Soo-Dam Kim ◽  
Ji Hye Park ◽  
So-Jung Park ◽  
Mi-Kyung Jeong ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cancer Patients ◽  
Causes Of Death ◽  
Survival Rates ◽  
Current Status ◽  
Integrative Oncology ◽  
Recurrence Rates ◽  
Current State ◽  
Look Ahead

Cancer is one of the leading causes of death worldwide, and Korea is no exception. Humanity has been fighting cancer for many years, and as a result, we now have effective treatments such as chemotherapy, radiation, and surgery. However, there are other issues that we are only now beginning to address, such as cancer patients’ quality of life. Moreover, numerous studies show that addressing these issues holistically is critical for overall cancer treatment and survival rates. This paper describes how Korea is attempting to reduce cancer incidence and recurrence rates while also managing the quality of life of cancer patients. Integrative Oncology is the field that addresses these broad issues, and understanding the current state of integrative oncology in Korea is critical. The goal of this paper is to provide an overview of the current state of integrative oncology in Korea as well as to look ahead to future developments.

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