scholarly journals TRENDING HYBRID SURGERY FOR ANAL FISTULAE [FILAC + SLOFT] TO CURTAIL RECURRENCE SUCCEEDING IN 24 CASES

2020 ◽  
pp. 74-76
Author(s):  
Neeti Neha ◽  
Gaurikant Mishra
Keyword(s):  
Fistulous Tract ◽  
Fistula Tract ◽  
Hybrid Surgery ◽  
Surgical Methods ◽  
Recent Modification ◽  
Surgical Options ◽  
Pros And Cons ◽  
A Chain

Objective: The aim of the study is to evaluate the efficacy of upcoming operative combination of fistula laser tract closure [FiLaC] + submucosal ligation of fistula tract [SLOFT] in treating anal fistulae. Background: The treatment of anal fistulae is predominantly surgical. To attain a minimum recurrence healing, the surgical methods have gone through a chain of transitions. One of the fresh developments has been a hybrid of FiLaC and SLOFT, sometimes described as distal laser proximal SLOFT [DLPS] procedure. Materials and methods: The study was winded up on a total of 24 patients since September 2019 to August 2020. All, regardless of type of fistula, underwent an operative blend of FiLaC and SLOFT, after explaining the pros and cons of the bouquet of surgical options available. Results: The results of FiLaC and LIFT [Ligation of intersphincteric fistulous tract] have been individually questioned over past years. SLOFT is a recent modification inculcating the benefits of LIFT and at the same time, snagging for the cryptoglandular complex with minimal dissection. Conclusion: Our study on 24 cases has strengthened the togetherness of FiLaC and SLOFT in treating anal fistulae.

scholarly journals The Application of Different Surgical Methods in Endometrial Cancer

2021 ◽  
Vol 4 (1) ◽  
pp. 446-454
Author(s):  
Lu H ◽  
Huang C ◽  
Zhu S ◽  
Wei J ◽  
Shu S
Keyword(s):  
Endometrial Cancer ◽  
Da Vinci ◽  
Single Port ◽  
Sentinel Lymph Node Mapping ◽  
Clinical Value ◽  
Gynecological Malignancy ◽  
Lymph Node Mapping ◽  
Surgical Methods ◽  
Surgical Options ◽  
Pros And Cons

Endometrial cancer is a common gynecological malignancy in women, which accounts for the second in malignant tumor of female reproductive system. Obesity, high blood pressure and diabetes are risk factors for endometrial cancer. At present, the treatments of endometrial cancer focus on surgical treatment, followed by radiotherapy, chemotherapy and endocrine therapy. The progress of surgical method is transferring from traditional laparotomy, laparoscopy, single port laparoscope to Da Vinci robotic surgery system. Different surgical options should be personalized according to the patient’s situation. We compared the pros and cons of different surgical methods and introduced the clinical value of the Sentinel lymph node mapping in hope of giving some information for clinic.

scholarly journals Effectiveness of the ligation of intersphincteric fistula tract (LIFT) in the treatment of anal fistula: initial results

2014 ◽  
Vol 27 (2) ◽  
pp. 101-103 ◽  
Author(s):  
Sergio Danilo Tanahara TOMIYOSHI ◽  
Carlos Henrique Marques DOS SANTOS
Keyword(s):  
Fecal Incontinence ◽  
Anal Fistula ◽  
Anorectal Manometry ◽  
Fistulous Tract ◽  
Complete Healing ◽  
Fistula Tract ◽  
Anal Fistulas ◽  
Intersphincteric Fistula ◽  
The Mean ◽  
Initial Results

BACKGROUND: The abscesses and anal fistulas represent about 70% of perianal suppuration, with an estimated incidence of 1/10000 inhabitants per year and representing 5% of queries in coloproctology. AIM: To evaluate the effectiveness of the interesphincteric ligation technique of the fistulous tract in the treatment of anal fistula. METHODS: The records of eight patients who underwent this technique, evaluating age, gender and presence of incontinence were studied. Was named technical first-step the passage of cotton thread to promote the correct individualization of the fistula and, as the second, the surgical procedure. RESULTS: Two patients were men and eight women. The mean age was 42.8 years. Of these, seven (87.5%) had complete healing of the fistula; six were cured only with this procedure and one required additional operation with simple fistulotomy. Only one patient developed fecal incontinence which was documented by anorectal manometry. There were no deaths in this series. CONCLUSION: The interesphincteric ligation technique of the fistulous tract proved to be effective for the treatment of anal fistula and should not be discouraged despite the occurrence of eventual fecal incontinence.

scholarly journals A comparative study in the management of fistula in ANO using various modalities

2018 ◽  
Vol 5 (6) ◽  
pp. 2223 ◽  
Author(s):  
Ramachandra M. L. ◽  
Mayank Garg
Keyword(s):  
Fistulous Tract ◽  
Selection Method ◽  
Fistula Tract ◽  
Internal Opening ◽  
Necrotic Tissue ◽  
Fistula In Ano ◽  
Sphincter Function ◽  
Medical College ◽  
Operative Complications ◽  
Comparative Prospective Study

Background: Fistula in ano is a track that connects deeply the anal canal or rectum to the skin around the anus. Fistula in ano most commonly follows an anorectal sepsis1. The main principles of management of anal fistula are closure of internal opening of fistula tract, drainage of infection or necrotic tissue, and eradication of fistulous tract with preservation of sphincter function. The objectives were to compare the various aspects like per operative complications, post-operative complications, mean hospital stay in the treatment of fistula in ano using various modalities like fistulotomy, fistulectomy, setons and lift procedure.Methods: This is a randomised, comparative, prospective study of 80 cases of fistula in ano, presenting at surgical opd of K.R. Hospital, Mysore attached to Mysore Medical College and research Institute. Out of which, 20 cases are treated by fistulectomy, 20 by seton, 20 by fistulotomy and the rest 20 cases by LIFT procedure by random selection method, during period of NOVEMBER 1, 2016 to 31st October 2017.Results: Most common age of presentation is 31-40 years and more common in males then females (M:F= 2.3:1 ). Per operative complications include bleeding seen more in patients undergoing fistulectomy. Per operative course of LIFT procedure patients was complication free. Postoperative pain seen more in patients undergoing setons procedure.Conclusions: we conclude that LIFT procedure and Fistulotomy were acceptable procedures for simple, uncomplicated low lying and high lying fistula.

Reproduction in dogs part 1: surgical and non-surgical de-sexing options

2020 ◽  
Vol 25 (7) ◽  
pp. 1-9
Author(s):  
Vicki J Adams
Keyword(s):  
Population Control ◽  
Gonadotropin Releasing Hormone ◽  
Common Method ◽  
Potential Health ◽  
Releasing Hormone ◽  
Gonadotropin Releasing Hormone Agonist ◽  
Surgical Methods ◽  
Surgical Options ◽  
Disease Risks ◽  
Control Disease

This article summarises the surgical and non-surgical options for desexing dogs, using standardised terminology by defining the meaning of commonly used terms. Desexing has been historically recommended to help with population control, disease prevention and behaviour modification. Surgical methods of gonadectomy are the most common method for desexing in both owned and unowned dogs, with orchiectomy being the most common method of desexing male dogs. Surgical methods of desexing in females may refer to ovariohysterectomy, ovariectomy, salpingectomy or hysterectomy with or without an ovarian autograft (referred to as a so-called ‘ovary-sparing spay’). Non-surgical desexing methods include three broad categories: hormonal, immunological, and chemical or physical methods. The use of a gonadotropin-releasing hormone agonist as a method of inducing reversible infertility in dogs is discussed in detail, including a review of the physiological effects of surgical gonadectomy compared to a gonadotropin-releasing hormone agonist and potential health effects of each. There is a growing body of literature on the disease risks associated with whether a dog is intact or desexed, and by which method it has been desexed. This will be discussed in the next article.

Endocrine Active Pituitary Tumor

2018 ◽  
Author(s):  
Amol Raheja ◽  
William T. Couldwell
Keyword(s):  
Pituitary Tumor ◽  
Index Case ◽  
Current Evidence ◽  
Illustrative Case ◽  
Complication Management ◽  
Pituitary Macroadenoma ◽  
Review Of Literature ◽  
Management Options ◽  
Surgical Options ◽  
Pros And Cons

This chapter presents an illustrative case demonstrating the principles of diagnosis and management in endocrine active pituitary tumor. The index case involves a 30-year-old male patient who presented with phenotypic markers of acromegaly. On radiological and endocrinological evaluation, growth hormone–secreting pituitary macroadenoma was identified. The philosophy of decision-making and management paradigm is discussed to demonstrate the pros and cons of medical, radiation, and surgical options. Technical nuances of the surgical procedure and its complication management are stressed. A brief review of literature is included to elaborate on the current evidence, including outcomes for the various management options for such tumors, with special emphasis on multimodality management.

scholarly journals A prospective interventional study on ligation of intersphincteric fistula tract in patients with fistula-in-ano-as a tertiary care centre

2021 ◽  
Vol 8 (3) ◽  
pp. 968
Author(s):  
Pradeep Panwar ◽  
Richa Jain ◽  
Mohit Jain ◽  
Rajendra Bagree ◽  
Hetish M. Reddy ◽  
...  
Keyword(s):  
Anal Incontinence ◽  
Single Case ◽  
Fistulous Tract ◽  
Tertiary Care ◽  
Healing Time ◽  
Sphincter Preservation ◽  
Fistula Tract ◽  
Tertiary Care Centre ◽  
Fistula In Ano ◽  
Wound Healing Time

Background: Fistula-in-ano is a very common condition encountered in proctology OPD. The treatment of fistula-in-ano is difficult due to potential risk of recurrence and fecal incontinence. Ligation of Intersphincteric Fistulous Tract is new modality of treatment for the condition. LIFT is a sphincter preserving surgery, aim of our study to evaluate the effectiveness of LIFT surgery.Methods: We did LIFT surgery in 35 cases of intersphincteric and transsphincteric types of fistula-in-ano during the period of December 2019 to July 2020. Standard investigation protocol was followed in all cases. Evaluation of effectiveness of procedure done in terms of anal incontinence, wound healing time, recurrence rate and wound infection rate.Results: 35 patients (23 men, 12 women) were included with mean age of 40 SD 10.38 years. Most of study population have Inter sphincteric fistula (62.9%), and 37.1% participants have trans sphincteric fistula. Healing time was 10-15 days (42.9%) and mean healing time is 17 SD 4.25 days. We didn’t see a single case of anal incontinence with LIFT in our study. 6 cases of recurrence were seen.Conclusions: Result from our study showed that LIFT surgery is effective modality and fulfilling the outcome of sphincter preservation.

scholarly journals Evaluation of Fistulotomy with Immediate Sphincteric Reconstruction in the Treatment of High Transsphincteric Perianal Fistula

2021 ◽  
Vol 41 (03) ◽  
pp. 217-221
Author(s):  
Yasser A. Orban ◽  
Hossam Hassan Soliman ◽  
Ahmed M. El Teliti ◽  
Ali El-Shewy ◽  
Yasmine Hany Hegab ◽  
...  
Keyword(s):  
Fistulous Tract ◽  
Perianal Fistula ◽  
Complete Healing ◽  
University Hospital ◽  
Direct Access ◽  
Fistula Tract ◽  
Recurrence Rates ◽  
Fistula Treatment ◽  
High Perianal Fistula ◽  
Sphincteric Reconstruction

Abstract Background High perianal fistula treatment remains challenging, mainly due to the variability in success and recurrence rates as well as continence impairment risks. So far, no procedure can be considered the gold standard for surgical treatment. Yet, strong efforts to identify effective and complication-free surgical options are ongoing. Fistulotomy can be considered the best perianal fistula treatment option, providing a perfect surgical field view, allowing direct access to the source of chronic inflammation. Controversy exists concerning the risk of continence impairment associated with fistulotomy. The present study aimed to assess the outcomes of fistulotomy with immediate sphincteric reconstruction regaring fistula recurrence, incontinence, and patient satisfaction. Methods This interventional study was performed at the General Surgery Department of Zagazig University Hospital during the period from July 2018 to December 2019 on 24 patients with a clinical diagnosis of high transsphincteric fistula-in-ano. The fistulous tract was laid open over the probe placed in the tract. After the fistula tract had been laid open, the tract was curetted and examined for secondary extensions. Then, suturing muscles to muscles, including the internal and external sphincters, by transverse mattress sutures. Results Our study showed that 2 patients develop incontinence to flatus ∼ 8.3%.and only one patient develop incontinence to loose stool, 4.2%. Complete healing was achieved in 83% and recurrence was 16.6%. Conclusion Fistulotomy with immediate sphincteric reconstruction is considered to be an effective option in the management of high perianal fistula, with low morbidity and high healing rate with acceptable continence state.

scholarly journals LIGATION OF INTERSPHINCTERIC FISTULA TRACT AS AN ALTERNATIVE TREATMENT FOR PERIANAL FISTULA AT TERTIARY CARE HOSPITAL

2021 ◽  
Vol 3 (3) ◽  
pp. 53-58
Author(s):  
Nawaz Ali Dal ◽  
Ishrat Raheem Katyar ◽  
Mohammad Qasim Mallah ◽  
Ahsan Laghari ◽  
Shiraz Shaikh ◽  
...  
Keyword(s):  
Fistulous Tract ◽  
Tertiary Care ◽  
Perianal Fistula ◽  
Perianal Abscess ◽  
Sampling Technique ◽  
Fistula Tract ◽  
Care Hospital ◽  
Therapeutic Success ◽  
Preoperative Symptom ◽  
Intersphincteric Fistula

This study was aimed to evaluate clinical outcome of patients with perianal fistula operated with the ligation of intersphincteric fistula tract (LIFT) technique. The study was conducted at Department of Surgery, Liaquat University of Medical & Health Sciences, Jamshoro from July 2018 and August 2019. A total of 22 patients diagnosed with perianal fistula operated with the Ligation of Intersphincteric Fistula Tract (LIFT) technique were selected using non-probability consecutive sampling technique. Physical examination and magnetic resonance imaging (MRI) and/or endosonography (ES) were performed to make a confirmed diagnosis of fistula. They were classified according to Parks classification. All patients were subjected to intersphincteric fistulous tract ligation using the technique defined by Rojanasakul modified. There were 16 males and 6 females. Mean age was 42 years (range 23-68 years of age). Out of 22 patients, 17 patients had a history of perianal abscess drainage prior to surgery and an average preoperative symptom presentation was 2.2 years (range 0-10 years). Therapeutic success with first surgery was achieved in 77% and with a second surgery in 90%. None of this patients modified their preoperative Wexner. It was concluded that LIFT technique appears to be a convenient, reproducible, and effective surgical alternative. This provides an appropriate closing rate and without continence modification, Therefore indicated for complex cryptoglandular fistulas.  

The place of conventional anal fistula surgeries among modern surgical techniques included in the current anal fistula treatment algorithm

Nowa Medycyna ◽  
2016 ◽  
Vol 23 (4) ◽  
pp. 0-0
Author(s):  
Małgorzata Kołodziejczak ◽  
Przemysław Ciesielski
Keyword(s):  
Anal Fistula ◽  
Treatment Algorithm ◽  
Surgical Techniques ◽  
Fistula Tract ◽  
Recurrence Rates ◽  
Surgical Methods ◽  
Preparatory Stage ◽  
Anal Fistula Surgery ◽  
Advancement Flaps ◽  
Fistula Treatment

The high percentage of complications after anal fistula surgery have resulted inattempts to seek new surgical solutions, which involve both improving the existing conventional surgical methods, as well as the introduction of modern surgical techniques. Classical surgical methods, such as fistulotomy, fistulectomy and Hippocrates’ procedure (loose or cutting setons) still have their place in the modernfistula treatment algorithm, however, some of the indications have changed (e.g. Hippocrates’ technique) and even new indications have been introduced. The noveltiesare represented e.g. by the use of a loose seton as a preparatory stage in innovativesurgical techniques, such as laser obliteration, injecting stem cells into the fistula tractor ligation of intersphincteric fistula tract (LIFT). Advancement flaps were replacedby LIFT and laser techniques due to similar indications, higher efficacy and lowerinvasiveness of the latter ones. On the other hand, the LIFT procedure was replacedby laser obliteration in the treatment of non branching trans-sphincteric fistulasas a less invasive and equally effective method. Although techniques for closing thefistula tract with a plug or adhesives are still considered as minimally invasive, theyare unfortunately associated with high recurrence rates. Recently a new solutionhas appeared. It is known as BioLIFT and combines LIFT with the anal fistula plug.The estimated effectiveness of this procedure is 68.8%.

The Efficacy of Lumbar Hybrid Stabilization Using the DIAM to Delay Adjacent Segment Degeneration: An Intervention Comparison Study With a Minimum 2-Year Follow-up

2013 ◽  
Vol 73 (2) ◽  
pp. ons224-ons232 ◽  
Author(s):  
Chang-Hyun Lee ◽  
Seung-Jae Hyun ◽  
Ki-Jeong Kim ◽  
Tae-Ahn Jahng ◽  
Sang Hoon Yoon ◽  
...  
Keyword(s):  
Odds Ratio ◽  
Adjacent Segment Degeneration ◽  
Adjacent Segment ◽  
Comparison Study ◽  
Hybrid Surgery ◽  
Long Term Outcome ◽  
Hybrid Stabilization ◽  
Surgical Methods ◽  
Facet Joint Degeneration ◽  
Hybrid Group

Abstract BACKGROUND: Although posterior lumbar interbody fusion (PLIF) has a successful fusion rate, the long-term outcome of PLIF is occasionally below expectations because of adjacent segment degeneration (ASD). OBJECTIVE: To evaluate the ability of hybrid stabilization using DIAM (Device for Interspinous Assisted Motion) to delay ASD. METHODS: An intervention comparison study of 75 patients (hybrid, 25; PLIF, 50) was performed. The indications for hybrid stabilization were facet joint degeneration, Pfirrmann grade II to III, and stenosis at the rostral adjacent segment. The PLIF group consisted of patients matched for age, sex, and fusion. The hybrid stabilization procedure included traditional PLIF and DIAM installation at a superior adjacent segment. The outcomes were analyzed with a linear mixed model analysis. Conditional logistic regression was performed to calculate the odds ratio for the association of surgical methods. RESULTS: The hybrid group (24%) revealed fewer ASDs than the PLIF group (48%). Among ASDs, spondylolisthesis occurred more frequently in the PLIF group than the hybrid group. Hybrid surgery was significantly associated with ASD; the odds ratio for hybrid surgery was 0.28 compared with PLIF. Foraminal height of the PLIF group decreased more than the hybrid group (P = .01). Segmental mobility showed a greater increase in the PLIF group than the hybrid group (P = .04). However, the clinical outcomes did not show significant differences between the groups. CONCLUSION: Hybrid stabilization with DIAM and pedicle screws can be used for patients with facet degeneration at adjacent segments but should be further investigated.

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