CLINICAL CHARACTERISTICS, CLASSIFICATION AND RESULTS OF TREATMENT RECURRENT ANAL FISTULA

2019 ◽  
Author(s):  
Toulabouth Manothay ◽  
Doan Van Phu Nguyen
Keyword(s):  
Wound Healing ◽  
Surgical Treatment ◽  
Anal Fistula ◽  
Postoperative Hemorrhage ◽  
Healing Time ◽  
University Hospital ◽  
Fistula Tract ◽  
Cross Sectional ◽  
Recurrent Fistula ◽  
Results Of Treatment

Objectives: To evaluate the results of surgical treatment of recurrent anal fistula. Methods: This was a cross-sectional, descriptive study including 30 recurrent anal fistula patients who underwent surgery from March 2017 to August 2018 at Hue University Hospital of Medicine and Pharmacy and Hue Central Hospital. Results: Male/female radio was 4/1. The highest proportion was among the ages of 21 – 60 (90%). The most common clinical presentation was perianal discharge in 86.7% of cases. The average duration of disease was found to be 2.5 ± 1.7 months approximately. Early postoperative complications rate is. 36.7% including: air or facial incontinence (33.4%),,postoperative hemorrhage (3.s3%). Average wound healing time is 7.5 ± 2.3 weeks and delayed wound healing rate is 100%. Results of surgical treatment of recurrent fistula anal are good 90%, mid 6.7%, poor 3.3%. Conclusions: Surgical treatment of recurrent anal fistula must depend upon the understanding the relative between anal sphincter and fistula tract. Surgical procedures have to be suitable for each type of anal fistulas. Key words: anal fistula, recurrent, surgical treatment

scholarly journals MODIFIED METHODS OF SURGICAL TREATMENT REST OF THE RECT

2020 ◽  
pp. 151-155
Author(s):  
I. A. Kryvoruchko ◽  
I. V. Sorokina ◽  
K. Y. Parkhomenko ◽  
T. N. Firsik ◽  
A. P. Bozhko
Keyword(s):  
Surgical Treatment ◽  
Anal Fistula ◽  
Fistula Tract ◽  
Rectal Fistula ◽  
Complete Excision ◽  
Modified Method ◽  
Minimal Damage ◽  
Significant Addition ◽  
Standard Techniques

Summary. The use of mini-invasive technologies for the treatment of rectal fistula prevents many postoperative complications. Complete excision of the rectal fistula is not the only important result of treatment. Ensuring a high quality of life for patients is also very important. The proposed methods of surgical correction are a significant addition to the list of existing operations. Objective. To compare and analyze the results of the treatment patients with anal fistula by using standard techniques, the modified method LIFT and excision anal fistula with biowelding. Materials and methods. A retro- and prospective study of the surgical treatment of 90 patients with uncomplicated transsphincteric anal fistula using different techniques from September 2018 to February 2020 was conducted. Results. The introduction of these methods has shown a decrease in the number of relapses. This was achieved by combining complete excision of the fistula tract and minimal damage to the sphincter complex. Conclusion. The use of combined methods of surgical treatment of rectal fistula has significant advantages over standard techniques.

scholarly journals Profile of renal trauma victims treated at a university hospital in Curitiba

2016 ◽  
Vol 43 (5) ◽  
pp. 341-347 ◽  
Author(s):  
CESAR AUGUSTO BROSKA JÚNIOR ◽  
ANDRÉ DE CASTRO LINHARES ◽  
ANDRÉ MONTES LUZ ◽  
CARLOS ROBERTO NAUFEL JÚNIOR ◽  
MARIANA SANTOS DE-OLIVEIRA ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Treatment Group ◽  
Conservative Treatment ◽  
Early Morning ◽  
Kidney Damage ◽  
University Hospital ◽  
Renal Trauma ◽  
Cross Sectional ◽  
Kidney Trauma ◽  
Motorcycle Accidents

ABSTRACT Objective: to study the profile of victims of kidney trauma who underwent surgical and medical treatment in a hospital in Curitiba. Methods: we conducted a retrospective, analytical, quantitative, cross-sectional study of patients with renal trauma admitted to the Evangelical Hospital of Curitiba between February 2011 and January 2014. Results: participated in the study 38 patients, four women and 34, men with a mean age of 28.4 years. Most injuries (60.5%) was due to closed mechanisms, especially motorcycle accidents. Injuries were treated conservatively in most cases. Patients who required surgical treatment had severe kidney damage or some other associated lesion, usually intra-abdominal. Hospital stay was lower in the conservative treatment group (10.8 days) compared with the surgical treatment one (18.8 days); mortality was also lower in the conservative treatment group (8.3%) compared with the surgical (14.3%). There were no deaths associated to kidney damage itself. Conclusion: patients with renal trauma in this study were young men, victims of motorcycle accidents, taking place during the night and early morning. Most injuries were treated conservatively.

scholarly journals Root extractive from Daphne genkwa benefits in wound healing of anal fistula through up-regulation of collagen genes in human skin fibroblasts

2017 ◽  
Vol 37 (2) ◽  
Author(s):  
Dong Yang ◽  
Jun-hua Xu ◽  
Ren-jie Shi
Keyword(s):  
Wound Healing ◽  
Human Skin ◽  
Anal Fistula ◽  
Healing Time ◽  
Skin Fibroblasts ◽  
Human Skin Fibroblasts ◽  
Protein Levels ◽  
Daphne Genkwa

Wound healing is the main problem in the therapy of anal fistula (AF). Daphne genkwa root has been traditionally used as an agent to soak sutures in operation of AF patients, but its function in wound healing remains largely unclear. The aim of the present study was to illuminate mechanisms of D. genkwa root treatment on AF. In the present study, 60 AF patients after surgery were randomly divided into two groups, external applied with or without the D. genkwa extractive. Wound healing times were compared and granulation tissues were collected. In vitro, we constructed damaged human skin fibroblasts (HSFs) with the treatment of TNF-α (10 μg/ml). Cell Count Kit-8 (CCK-8) and flow cytometry analysis were used to determine the effects of D. genkwa root extractive on cell viability, cell cycle and apoptosis of damaged HSFs. Furthermore, protein levels of TGF-β, COL1A1, COL3A1, Timp-1, matrix metalloproteinase (MMP)-3 (MMP-3) and MEK/ERK signalling pathways were investigated both in vivo and in vitro. Results showed that D. genkwa root extractive greatly shortens the wound healing time in AF patients. In granulation tissues and HSFs, treatment with the extractive significantly elevated the expressions of COL1A1, COL3A1, Timp-1, c-fos and Cyclin D1, while reduced the expression of MMP-3. Further detection presented that MEK/ERK signalling was activated after the stimulation of extractive in HSFs. Our study demonstrated that extractive from D. genkwa root could effectively improve wound healing in patients with AF via the up-regulation of fibroblast proliferation and expressions of COL1A1 and COL3A1.

scholarly journals A prospective interventional study of postoperative pain, healing rates and incontinence rates following ligation of intersphincter fistula tract procedure

2018 ◽  
Vol 5 (12) ◽  
pp. 3976
Author(s):  
Arunraj P. ◽  
Viswanathan M. S. ◽  
Anbazhagan R. ◽  
Kulwant Singh
Keyword(s):  
Wound Healing ◽  
Postoperative Pain ◽  
Anal Fistula ◽  
Fistula Tract ◽  
Fistula In Ano ◽  
Sphincter Function ◽  
Incontinence Score ◽  
Group A ◽  
Complete Wound Healing ◽  
Group B

Background: Fistula in ano is one of the oldest ailments known to us, troublesome both to the patient and also challenging to the treating surgeon. The treatment of fistula in ano has evolved so much, to reduce complications and to improve patient’s compliance. This study was conducted to compare the age old method of open fistulectomy to that of recently developed technique of ligation of intersphincter fistula tract (LIFT), in patients suffering from low fistula in ano.Methods: A totally of 80 patients, suffering from low anal fistula was divided randomly into two groups. Group A: undergoing LIFT procedure and Group B: undergoing open fistulectomy procedure .The two groups were compared in the postoperative period for wound healing, postoperative pain (by visual analog scale) and fecal incontinence (by Wexner incontinence score).Results: Group A patients who underwent LIFT at the end of 3rd postoperative week had a pain score of 0.43 when compared to group B patients (1.33) who underwent fistulectomy. Group A patients had 100% continence preservation, whereas a 17.5% of moderate incontinence was documented in Group B patients. About 97.5% of patients under Group A had complete wound healing by the 3rd postoperative week, as compared to group B patients, where100% complete wound healing was noted at 6 weeks, postoperatively.Conclusions: It was found that LIFT was a promising procedure in reducing the postoperative pain significantly, with better wound healing rates. It was effective in maintaining good sphincter function, thereby providing better faecal continence following surgery, in low anal fistula.

scholarly journals Ligation of the Intersphincteric Fistula Tract (LIFT) Technique in the Treatment of Complex Perianal Fistula: Experience of First 50 Cases

2020 ◽  
Vol 15 (1) ◽  
pp. 3-7
Author(s):  
Swapan Kumar Biswas ◽  
ASM Tanjilur Rahman ◽  
Muhammad Mofazzal Hossain ◽  
Saiful Islam Khan
Keyword(s):  
Tissue Injury ◽  
Surgical Techniques ◽  
Perianal Fistula ◽  
Healing Time ◽  
Good Choice ◽  
Fistula Tract ◽  
Common Disease ◽  
College Hospital ◽  
Recurrent Fistula ◽  
Intersphincteric Fistula

Perianal fistula is a common disease and surgery is the only treatment option. Many surgical techniques have been described. Ligation of intersphincteric fistula tract (LIFT) is a sphincter saving surgical technique in which fistula tract is ligated and excised through intersphincteric approach. The aim of study is to present our experience of first 50 LIFT procedures particularly healing rate, recurrence rate and complications from the procedure. This is a prospective observational study started from March 2018 on whom underwent LIFT procedure for primary complex perianal fistula of infective origin at Faridpur Central Hospital and Faridpur Medical College Hospital. In this study, 50 patients (42 male and 8 female) of average age of 39±7.6 years with complex fistula were included. The mean operative time was 34.7±5.67 minutes and most of the fistulas were transsphincteric variety (90%). Median wound healing time was 21.45±6.34 days for intersphincteric wound and 26.78±6.93 days for the external opening of the fistula. Mean follow up period was 10.5 months. Seven patients of our series developed recurrent fistula, making the overall success of 86%. None of the patient in our series developed incontinence. LIFT procedure has the advantage of preservation of anal sphincter, minimal tissue injury, shorter healing time, relatively easy to perform, and high success rate. It's a good choice for treatment of complex perianal fistula. Faridpur Med. Coll. J. Jan 2020;15(1): 3-7

Treatment of Complex Anal Fistula by Video-Assisted Anal Fistula Treatment Combined with Anal Fistula Plug: A Single-Center Study

2021 ◽  
pp. 155335062199292
Author(s):  
Yuru Zhang ◽  
Fei Li ◽  
Tuanjie Zhao ◽  
Feng Cao ◽  
Yamin Zheng ◽  
...  
Keyword(s):  
Wound Healing ◽  
Anal Fistula ◽  
Healing Time ◽  
Sphincter Function ◽  
Anal Sphincter Function ◽  
Fistula Plug ◽  
Anal Fistula Plug ◽  
Fistula Treatment ◽  
Wound Healing Time

Objective. The surgical treatment of complex anal fistulae is very challenging because of the incidence of incontinence after traditional approaches. There are no studies on the role of video-assisted anal fistula treatment (VAAFT) combined with anal fistula plug (AFP) in the complex anal fistulae. The aim of this study was to demonstrate the efficacy of treating complex anal fistulae using VAAFT combined with AFP. Method. This was a retrospective, nonrandomized observational study. 57 consecutive patients with complex anal fistulae who had undergone the VAAFT with AFP in our hospital between April 2016 and December 2019 were included. The primary outcomes were the cure rate, recurrence rate, and Wexner incontinence scores; the secondary outcomes were surgery time, blood loss, wound healing time postoperatively, pain, and patient satisfaction. Results. All 57 patients completed the surgery and follow-up, with an average follow-up time of 28 months; 6 patients suffered with recurrence (recurrence rate: 10.5%). The average surgery time was 57.9 minutes, and the average wound healing time was 46 days. There were no severe postoperative complications, and anal sphincter function was protected in all patients. Conclusions. The treatment of complex anal fistula by VAAFT combined with AFP is safe and effective, has a high healing rate and few postoperative complications, and is a promising surgery that can effectively protect the patient’s anal sphincter function.

scholarly journals Factors Associated with Surgical Treatment Outcome of Psoas Muscle Abscess

2021 ◽  
pp. 91-95
Author(s):  
Shahida Khatoon ◽  
Shiraz Shaikh ◽  
Abdul Salam Memon ◽  
Shahnawaz Khatti ◽  
Aijaz Ahmed Shaikh ◽  
...  
Keyword(s):  
Treatment Outcome ◽  
Surgical Treatment ◽  
Psoas Abscess ◽  
Surgical Techniques ◽  
Psoas Muscle ◽  
Careful Consideration ◽  
University Hospital ◽  
Abscess Cavity ◽  
Cross Sectional ◽  
Factors Associated

Background: Psoas abscess is a rare condition but one with potential for severe morbidity. Many factors may be implicated in the treatment outcome of the condition and efforts must be directed to identify, understand and control the factors for a better prognosis. Objective: To identify the factors associated with surgical treatment outcome of psoas muscle abscess. Methodology: This descriptive cross-sectional study was conducted upon a sample of 58 patients (chosen via non-probability, consecutive sampling) scheduled for surgical treatment for psoas muscle abscess (aged 18 to 60 years) at department of General Surgery at Liaquat University Hospital, Hyderabad & Jamshoro. All the patients underwent surgical treatment. The data was recorded via pre-structured questionnaire comprising of inquiries pertaining to socio-demographic details, presenting complaints, and factors association with surgical treatment outcome (in terms of resolution of abscess cavity). Data was analyzed via SPSS version 20. Results: Mean age of study subjects was 37.6 ± 12.5 years. Out of all 72.4% were males and 27.5% were females. Most common presentation of patients was pain in flanks, followed by fever. The commonest etiological factor was tuberculosis (TB) and consequently spinal (TB) was the most common. Resolution of abscess cavity was noted among 77.5% of the cases with a greater proportion of recovery falling in line non- tuberculous etiology. Conclusions: After careful consideration, it can be concluded that secondary psoas muscle and that with tuberculous etiology have a poorer surgical outcome, thus greater care and more effective surgical techniques may be employed to achieve complete resolution of abscess.

scholarly journals TYMPANOPLASTY TYPE-1: DIFFERENT APPROACHES AND THEIR SURGICAL OUTCOMES

2021 ◽  
Vol 71 (Suppl-3) ◽  
pp. S495-99
Author(s):  
Fazal I Wahid ◽  
Abdul Manan ◽  
Muhammad Saleem ◽  
Bakht Zada ◽  
Habib -Ur- Rehman ◽  
...  
Keyword(s):  
Wound Healing ◽  
Postoperative Pain ◽  
Surgical Outcomes ◽  
Neck Surgery ◽  
Healing Time ◽  
Cross Sectional ◽  
Female Ratio ◽  
Significant Difference ◽  
Wound Healing Time

Objective: To calculate the surgical outcomes of different approaches of tympanoplasty type 1 in terms of air bone gap closure, wound healing, and postoperative pain. Study Design: Prospective cross-sectional study. Place and Duration of Study: Department of ENT, Head and Neck Surgery, Medical Teaching Institute (MTI), Lady Reading Hospital (LRH), Peshawar, Pakistan from Jun 2018 to May 2020. Methodology: Size of sample was 75 patients divided into three groups. Consent was obtained from all the patients included in study. After proper evaluation and relevant investigation pre- and post-operative PTA was performed. Tympanoplasty type-1 was performed by the same surgeon by the three approaches following established otological surgical protocol. Collected data was entered in SPSS-25 for analysis. Results: All 75 patients were divided into three equal groups. Male were 55 (73.3%), females were 20 (26.7%). Male: female ratio was 2.7:1. Majority of patients presented in 2nd and 3rd decades of life 31 (41.33%) and 28 (37.33%) respectively. Preoperative mean ± SD, ABG in groups A, B and C were 37.60 ± 11.28 dB, 37 ± 9.68 dB and 31.80 ± 12.40 dB, respectively. No significant difference was found amongst the three groups regarding pre-operative and post-operative ABG (p=0.85 and p=0.4), respectively. Mean ± SD, wound healing time in Groups A, B and C were 1.00 ± 0.00, 1.80 ± 0.40 and 1.76 ± 0.43 respectively with p=0.0001 and similarly postoperative pain with p=0.001. The wound healing time and post-operative was statistically better (p<0.05) in group A (Transmeatal approach) than other groups........

scholarly journals Wound Healing Post-mesh Repair ― An Observational Study

2016 ◽  
Vol 33 (2) ◽  
pp. 69
Author(s):  
M.N Lebbe ◽  
J Kularajasingham ◽  
P Dioso
Keyword(s):  
Wound Healing ◽  
Mesh Repair ◽  
Surgical Mesh ◽  
Surgical Techniques ◽  
Cross Sectional Study ◽  
Healing Time ◽  
Cluster Sampling ◽  
Cross Sectional ◽  
The Common ◽  
Repair Techniques

This study identified the best surgical mesh repair techniques for inguinal hernia and prevalence of wound healing post-mesh repair. The cross-sectional study design used cluster sampling for data collection. Of the 120 respondents, 48.3% preferred anterior tension-free mesh repair and 49.2% Lichtenstein mesh repair, both identified as the common surgical techniques in eastern Sri Lanka. About 82.5% of the respondents (n = 99) healed while 17% (n = 21) had recurrence of hernia after one month. Nevertheless, 2.5% of the total respondents said that the hernia repaired after one month but less than two months; and 97.5% of the interviewees stated that they recovered in less than one month regardless of the surgical mesh repair technique. Respondents aged 30–39 faced little impact on healing time with mesh repair (p = 0.4393), while those aged 40–49 probably had also longer healing time (p = 0.3947). Recovering period differed significantly (p = 0.862), on pain ordiscomfort, especially when bending over, coughing or lifting heavy objects.

scholarly journals Cell therapy in surgical treatment of fistulas. Preliminary results

2017 ◽  
Vol 89 (3) ◽  
pp. 48-51 ◽  
Author(s):  
Marcin Piejko ◽  
Michał Romaniszyn ◽  
Julia Borowczyk-Michałowska ◽  
Justyna Drukała ◽  
Piotr Wałęga
Keyword(s):  
Surgical Treatment ◽  
Cell Therapy ◽  
Subcutaneous Tissue ◽  
Perianal Fistula ◽  
Fistula Tract ◽  
Invasive Treatment ◽  
Recurrent Fistula ◽  
Intestinal Continuity ◽  
Natural Healing

Risk of recurrence after surgical treatment of a recurrent fistula is up to 50%. It has be known that more aggressive surgical treatment is associated with a high risk of anal sphincter damage and leads to incontinence. Several studies have been designed to elaborate minimally invasive treatment of rectovaginal and anal fistulas. The properties of Adipose-derived Stem Cells (ASC) significantly enhance a natural healing potency. Here, we present our experience with combined surgical and cell therapy in the treatment of fistulas. Materials and Methods: Four patients were enrolled in our study after unsuccessful treatments in the past – patients 1-3 with rectovaginal fistulas including two women after graciloplasty, and patient 4 - a male with complex perianal fistula. Adipose tissue was obtained from subcutaneous tissue. ASCs were isolated, cultured up to 10+/-2 mln cells and injected into the walls of fistulas. Follow-up physical examination and anoscopy were performed at 1, 4, 8, and 12 weeks, 6 and 12 months after implantation. Results: Up to 8 weeks after ASC implantation, symptoms of fistulas’ tracts disappeared. At 8 weeks, in patients 1-3, communication between vaginal and rectal openings was closed and at 12-16 w. intestinal continuity was restored in patient 3 and 4. After a 6-month follow-up, the fistula tract of patient 4 was closed. Up to 12 m. after ASC implantation no recurrences or adverse events were observed. Conclusion: ASCs combined with surgical pre-treated fistula tracts were used in four patients. All of them were healed. This encouraging result needs further trials to evaluate the clinical efficiency and the cost-effectiveness ratio.

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