Analysis of treatment methods and outcomes for perianal abscess (PA) and fistula in ano (FIA) in infants

Nowa Medycyna ◽  
2020 ◽  
Vol 27 (2) ◽  
Author(s):  
Michał Puliński ◽  
Natalia Hawryluk ◽  
Wojciech Choiński
Keyword(s):  
Surgical Treatment ◽  
Hospital Stay ◽  
Retrospective Analysis ◽  
Perianal Abscess ◽  
Paediatric Surgery ◽  
Common Condition ◽  
Incision And Drainage ◽  
Treatment Methods ◽  
Fistula In Ano ◽  
Children's Hospital

Introduction. Perianal abscess (PA) is a relatively common condition in children and occurs in 0.5 to 4.3% of the infant population. In the majority of cases, it is associated with fistula in ano (FIA). Surgical treatment of FIA includes fistulectomy, fistulotomy or, rarely, cryptotomy. Aim. The aim of the study is to perform a retrospective analysis of treatment methods and outcomes for PA and FIA in infants at the Department of Paediatric Surgery and Urology of the Regional Specialised Children’s Hospital in Olsztyn, Poland, in 2014-2019. Material and methods. From January 2014 to December 2019, 44 infants with diagnosed PA and FIA were treated. The majority of patients were boys: 41 (93%) and only 3 (7%) were girls. For PA, three different treatment methods were used: incision and drainage, fistulotomy or fistulectomy. Results. Out of 44 treated infants with diagnosed PA and FIA, 29 were treated only by incision and drainage. Among them, 19 were cured. FIA was identified in 9 patients and fistulectomy or fistulotomy was performed. In this group, there was 1 recurrence, which was retreated with fistulectomy and cured. In 6 patients, PA drained spontaneously; in 3 of them there was recurrence and FIA was diagnosed during another hospital stay. There were 7 fistulotomies and 14 fistulectomies performed and their efficacy was 100 vs 93%, respectively. Conclusions. Fistulotomy is the most effective and safest method of FIA treatment in infants. In every case of perianal abscess diagnosis, a fistula in ano should be looked for.

scholarly journals 27 Do Microbiology Swabs Taken During Incision and Drainage of Acute Perianal Abscess Affect Clinical Management and Future Clinical Course?

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
A O'Connor ◽  
S Sabri ◽  
S Ullah
Keyword(s):  
Clinical Course ◽  
Smoking Status ◽  
Perianal Abscess ◽  
Microbiological Analysis ◽  
Inclusion Criteria ◽  
National Scale ◽  
Incision And Drainage ◽  
Fistula In Ano ◽  
Diabetic Status ◽  
Organism Growth

Abstract Introduction This study assesses whether microbiology swabs taken during incision and drainage of perianal abscesses have any impact on the post-operative clinical course and management. Method Data from emergency operative theatre lists were interrogated for patients undergoing incision and drainage of perianal abscess in the period March 2019 – March 2020. Each electronic medical record for patients who had perianal abscess surgery was interrogated for age, sex, smoking status, diabetic status, whether microbiology swab was taken for analysis, what organism was grown and any post-operative fistula development. Results 71 patients met inclusion criteria. 55 (77.5%) patients had pus swabs sent at incision and drainage for microbiological analysis. Of the 55 patients swabbed, 20 (36%) had no organism growth, 22 (40%) had anaerobes growth – the most common organism in this study. Of all 55 swabs sent, only 14 (25%) were acknowledged. The presence of smoking (p < 0.05) was statistically significantly associated with development of fistula-in-ano longer term. Conclusions Our data may indicate that microbiology swabs do not influence management of patients with acute perianal abscess. There are discrepancies in whether swabs are taken and acted upon. No organism was associated with fistula development. We would suggest national scale studies to explore our conclusions.

scholarly journals THE NEAREST RESULTS OF LAPOROSCOPIC SURGERY FOR CARDIOSPASM (ACCORDING TO THE MATERIALS OF THE CLINIC)

2020 ◽  
Vol 74 (2) ◽  
pp. 81-83
Author(s):  
A.A. Polyantsev ◽  
◽  
V.V. Kotrunov ◽  
A.A. Polyantsev (jr.) ◽  
A.G. Zimin ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
Surgical Treatment ◽  
Thoracic Surgery ◽  
Hospital Stay ◽  
Retrospective Analysis ◽  
Partial Fundoplication ◽  
Clinical Hospital

The retrospective analysis of nearest results of laparoscopic surgery for cardiospasm was provided according to the materials of the department of thoracic surgery of the «Volgograd Regional clinical Hospital №1» for 2018–2020. The research included 32 laparoscopic surgical treatment cases of cardiospasm II–III stage with Heller’s method with Nissen’s fundoplication or partial fundoplication after Tupa (270 ºС). Analysis of the nearest results of laparoscopic surgery for cardiospasm rated the advantages of the laparoscopic method in perfoming exstramucosal esophagocardiomyotomy are assessed. The traumatism and time of the operation decreasewas marked, it was reduced the patients hospital stay and postoperation rehabilitation was also redused in patients with II–III stage of the disease.

scholarly journals THE NEAREST RESULTS OF LAPOROSCOPIC SURGERY FOR CARDIOSPASM (ACCORDING TO THE MATERIALS OF THE CLINIC)

2020 ◽  
Vol 76 (4) ◽  
pp. 50-52
Author(s):  
A.A. Polyantsev ◽  
◽  
V.V. Kotrunov ◽  
A.A. Polyantsev (jr.) ◽  
A.G. Zimin ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
Surgical Treatment ◽  
Thoracic Surgery ◽  
Hospital Stay ◽  
Retrospective Analysis ◽  
Marked Decrease ◽  
Clinical Hospital

Aim of the research. To provide retrospective analysis of nearest results of laparoscopic surgery for cardiospasm (according to the materials of the department of thoracic surgery of the «Volgograd Regional clinical Hospital № 1» for 2018–2020). Materials and methods. The research include 32 laparoscopic surgical treatment cases of cardiospasm II–III stage. Results. Analysis of the nearest results of laparoscopic surgery for cardiospasm rated the advantages of the laparoscopic method in perfoming exstramucosal esophagocardiomyotomy are assessed. Conclusion. Marked decrease traumatism and time of the operation. Redused the patients hospital stay and postoperation rehabilitation was also redused in patients with II–III stage of the disease.

scholarly journals EXPERIENCE OF TREATMENT OF NEWBORN CHILDREN WITH GASTROSCHISIS

2015 ◽  
Vol 174 (6) ◽  
pp. 46-51
Author(s):  
B. N. Bisaliev ◽  
N. A. Tsap
Keyword(s):  
Surgical Treatment ◽  
Hospital Stay ◽  
Enteral Feeding ◽  
Comparison Group ◽  
Main Group ◽  
Comparative Assessment ◽  
Treatment Results ◽  
Treatment Methods ◽  
Primary Radical ◽  
Operative Methods

The article presents an analysis of 10-year treatment results of 62 children with gastroschisis. Children were divided into two groups and it depended on the applied surgical treatment. An elimination of congenital eventration using Bianchi method was performed for children of the main group. The operative methods such as siloplasty, Gross operation, alloplasty and primary radical abdominoplasty were performed for children of comparison group. Comparative assessment of efficacy of the treatment methods of gastroschisis showed, that Bianchi method had a number of advantages: an early transition to independent breath and enteral feeding, shortening of hospital stay, decrease of the rate of lethality from 66,6% to 14,2%.

scholarly journals Incision and drainage of perianal abscess with primary fistulotomy in case of co-existing low variety fistula

2020 ◽  
Vol 28 (1) ◽  
pp. 85-89
Author(s):  
Mohammad Nazmul Hoque Masum ◽  
Asif Yazdani ◽  
Md Shahnawas Biswas ◽  
Mohammad Masum ◽  
Masfique Ahmed Bhuiyan ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Operative Time ◽  
Digital Rectal Examination ◽  
Perianal Abscess ◽  
Healing Time ◽  
Complete Healing ◽  
Repeat Surgery ◽  
Average Hospital ◽  
Incision And Drainage ◽  
Patient’S Satisfaction

Background: Perianal abscess is a clinical condition frequently encountered by surgeons. Perianal abscess originates from an infection arising in the cryptoglandular epithelium lining the anal canal. Occasionally; bacteria, fecal material or foreign matter can clog an anal gland and tunnel into the tissue around the anus or rectum, where it may then collect in a cavity called an abscess. About half of perianal abscess may manifest as fistula-in-ano which increases the risk of abscess recurrence requiring repeated drainage. Treating the fistula at the same time of incision and drainage of abscess reduce chances of recurrent abscess development and therefore likelihood of repeat surgery. Primary fistulotomy in case of low variety fistula may be advantageous for perianal abscess because fistulas are more commonly traceable and can be laid open with full preservation of external anal sphincters. Methods: 216 consecutive patients (91.6% males, 8.33% females); mean age, 39 (range 18-70 years) from July, 2015 to January, 2019 with perianal abscesses were treated by incision and drainage and primary fistulotomy. 38 patients had comorbidities as diabetes mellitus, obesity (BMI>26), tuberculosis. Patients were followed up clinically for 2 months. Digital rectal examination performed to assess anal tone before, one week and one month after surgery. Results: Operative time was on average 17 minutes (15-20 minutes). Average hospital stay was 1 day and complete healing time ranged from 30-60 days. Persistent fistulas developed in four patients after surgery (1.85%). Bleeding occurred in 2 patients (1%). Many patients had transient minor incontinence in the form of flatus and loose stool incontinence but eventually resolved after two weeks. No major incontinence was found. Patient’s satisfaction of the treatment maneuver in relation to abscess recurrence and fistula occurrence was 95%. All patients remained fully continent. Operative time, hospital stay, and time for complete wound healing were the same in both groups. Conclusion: Primary fistulotomy for co-existing low variety fistula at the time of drainage of perianal abscess results in very few persistent fistulas and no added risk of fecal incontinence. J Dhaka Medical College, Vol. 28, No.1, April, 2019, Page 85-89

Antibiotic therapy for prevention of fistula in-ano after incision and drainage of simple perianal abscess: A randomized single blind clinical trial

Surgery ◽  
2017 ◽  
Vol 162 (5) ◽  
pp. 1017-1025 ◽  
Author(s):  
Leila Ghahramani ◽  
Mohammad Reza Minaie ◽  
Peyman Arasteh ◽  
Seyed Vahid Hosseini ◽  
Ahmad Izadpanah ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Antibiotic Therapy ◽  
Perianal Abscess ◽  
Incision And Drainage ◽  
Fistula In Ano ◽  
Single Blind

scholarly journals Stuttering after Intravenous Anesthesia: A Case Report

2021 ◽  
Vol 59 (241) ◽  
pp. 929-931
Author(s):  
Suraj Lamichhane ◽  
Murari Raj Upreti ◽  
Yogesh Dhakal
Keyword(s):  
Case Report ◽  
Hospital Stay ◽  
Male Patient ◽  
Speech Therapy ◽  
Past History ◽  
Perianal Abscess ◽  
Speech Disorder ◽  
Intravenous Anesthesia ◽  
Incision And Drainage ◽  
Significant Challenge

Stuttering is a form of speech disorder characterized by involuntary prolongation and repetition of sound, words, syllables or phrases as well as involuntary silent pauses or blocks. We report a case of a healthy twenty-six-year-old male patient without significant past history, who underwent short intravenous anesthesia for incision and drainage for perianal abscess. Postoperatively, the patient presented with prominent stuttering after six hours of surgery. To our knowledge, this is the first reported case of stuttering following short intravenous anesthesia without any airway manipulation. He was diagnosed with a functional speech disorder after excluding organic causes. His speech eventually normalized with six weeks of intensive speech therapy. This event posed a significant challenge for the surgical and anesthesia team to find the potential cause, to plan further management, and lead to two days prolongation of hospital stay.

Perianal abscess and fistula-in-ano in children – evaluation of treatment’s efficacy. Are we able to avoid the recurrence?

2020 ◽  
Vol 92 (1) ◽  
pp. 1-5
Author(s):  
Katarzyna Bałaż ◽  
Agata Trypens ◽  
Dariusz Polnik ◽  
Katarzyna Pankowska-Woźniak ◽  
Piotr Kaliciński
Keyword(s):  
Antibiotic Therapy ◽  
Recurrence Rate ◽  
Perianal Abscess ◽  
High Recurrence Rate ◽  
Invasive Approach ◽  
Incision And Drainage ◽  
Surgical Interventions ◽  
Fistula In Ano ◽  
Group I ◽  
Group Ii

AIM Perianal abscess and fistula-in-ano are common findings in infants and children. The perianal abscess is usually a manifestation of the fistula-in-ano. Experience of our center indicates a general lack of knowledge of the abscess’s origin therefore it is usually treated by incision and drainage which leads to numerous recurrence. We aimed to present the optimal management of the fistula-in-ano and perianal abscess to lower or even eliminate recurrences. METHOD The retrospective study consisted of 24 infants treated in our center with perianal abscess from 2013 to 2015. The patients were divided into two groups: group I (50%) was primary treated in our center, group II had prior surgical interventions in other hospitals. Fistula-in-ano was intraoperatively identified in all patients (100%) and fistulotomy was performed. RESULTS No recurrence of the perianal abscess or fetal incontinence were observed in any patient. In the group II, the ailment was associated with severe inflammation, some patients underwent an additional surgical intervention such as incision and drainage of the extensive buttock’s abscess; the patients required longer antibiotic therapy and longer hospitalization. CONCLUSION Low-invasive approach (hip-bath, antibiotic therapy, puncture or incision and drainage of the abscess) seems to be tempting due to its simplicity and no need of general anesthesia but it is associated with high recurrence rate. Fistulotomy and fistulectomy, which are slightly more invasive procedures, significantly lower the recurrence rate of fistula-in-ano and perianal abscess.

scholarly journals Does antibiotic therapy prevent fistula in-ano after incision and drainage of simple perianal abscess?

2020 ◽  
Vol 63 (4) ◽  
pp. E362-E364
Author(s):  
Mantaj S. Brar ◽  
Feza Remzi ◽  
Janindra Warusavitarne ◽  
Indraneel Datta ◽  
Keyword(s):  
Antibiotic Therapy ◽  
Perianal Abscess ◽  
Incision And Drainage ◽  
Fistula In Ano
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