Year 2020 / Volume 112 / Number 11
Original
Rectal advancement flaps for the treatment of transphincteric perianal fistulas: a three-dimensional endoanal ultrasound and quality of life assessment

860-863

DOI: 10.17235/reed.2020.7187/2020

Marina Garcés Albir, Stephanie Anne García-Botello, Vicente Pla-Martí, José Martín-Arévalo, David Moro-Valdezate, Alejandro Espi, Joaquín Ortega,

Abstract
This study quantifies the damage to the internal anal sphincter (IAS) after a rectal mucosal advancement flap for a high transphincteric fistula in 16 patients using 3D-endoanal ultrasound. This was correlated with postoperative incontinence and quality of life scores. The median length of involved IAS preoperatively was 50 % (20-100) and 93.72 % for EAS (47.4-100 %). IAS division did not influence continence (p > 0.05). Continence deteriorated between the pre-, postoperative (p = 0.014) and six-month follow-up (p = 0.005), with no significant differences after one year (p > 0.05). The FIQOL score and SF-36 deteriorated initially, with recovery in all domains except for mental health after one year. Three fistulas recurred (18.75 %).
Share Button
New comment
Comments

15/11/2023 20:37:50
твой кролик писал


References
García-Aguilar J, Belmonte G, Wong WD, et al. Anal fistula surgery. Factors associated with recurrence and incontinence. Dis Colon Rectum 1996;39:723-29.
2 Roig JV, Jordán J, García-Armengol J, et al. Changes in anorrectal morphologic and functional parameters after fistula-in-ano surgery. Dis Colon Rectum 2009;52:1462-69.
3 Minguez M, Garrigues V, Soria MJ, et al. Adaptation to Spanish Language and Validation of the Fecal Incontinence Quality of Life Scale. Dis Colon Rectum 2006;49:490-9.
4 Jorge JM, Wexner SD. Etiology and management of fecal incontinence. Dis Colon Rectum 1993;36:77-97.
5 Keighley MRB, Williams NS (2008) Fecal incontinence. In: Surgery of the anus, rectum and colon, 3rd edn. Elsevier, Philadelphia, p593. ISBN: 9780702027239
6 Garcés-Albir M, García-Botello SA, Esclapez-Valero P, et al. Quantifying the extent of fistulotomy. How much sphincter can we safely divide? A three-dimensional endosonographic study. Int J Colorectal Dis 2012;27:1109-16.
7 Mizrahi N, Wexner SD, Zmora O, et al. Endorectal advancement flap: are there predictors of failure? Dis Colon Rectum 2002;45:1616-21.
8 Madbouly KM, El Shazly W, Abbas KS, et al. Ligation of intersphincteric fistula tract verus mucosal advancementflap in patients with high transsphincteric fistula-in-ano: a prospective randomized trial. Dis Colon Rectum 2014;57:1202-8.
9 Dubsky PC, Stift A, Friedl J, et al. Endorectal advancement flaps in the treatment of high anal fistula of cryptogladular origin: full-thickness vs. mucosal rectum flaps. Dis Colon Rectum 2008;51:852-7. doi: 10.1007/s10350-008-9242-3
10 De la Portilla F., Segura-Sampedro JJ., Reyes-Díaz ML., et al. Treatment of transphincteric fistula-in-ano with growth factors from autologous platelets: results of a phase II clinical trial. Int J Cororectal Dis 2017; 32:1545-1550.
11 Van del Hagen SJ., Baeten CG., Soeters PB., et al. Autologous platelet-derived growth factors (platelet-rich plasma) as an adjunct to mucosal advancement flap in high crytptoglandular perianal fistulae: a pilot study. Colorectal Dis 2011;13:215-218.
12 Garcia-Olmo D., Guadalajara H., Rubio-Prez I., et al. Recurrent anal fistulae: Limited surgery supported by stem cells. World J Gastroenterol 2015; 21: 3330-3336.
13 Garcia-Arranz M, Garcia-Olmo D, Herreros MD, et al.; FISPAC Collaborative Group. Autologous adipose-derived stem cells for the treatment of complex cryptoglandular perianal fistula: A randomized clinical trial with long-term follow-up. Stem Cells Transl Med 2020; 9:295-301.
14 Joy H, Williams JG. The outcome of surgery for complex anal fistulas. Colorectal Dis 2002;4:254-61.
15 Balciscueta Z, Uribe N, Balciscueta I, et al. Rectal advancement flap for the treatment of complex cryptoglandular anal fistulas: a systematic review and meta-analysis. Int J Colorectal Dis 2017;32:599-609.
Related articles

Original

Coping with celiac disease: how heavy is the burden for caregivers?

DOI: 10.17235/reed.2017.4518/2016

Citation tools
Garcés Albir M, García-Botello S, Pla-Martí V, Martín-Arévalo J, Moro-Valdezate D, Espi A, et all. Rectal advancement flaps for the treatment of transphincteric perianal fistulas: a three-dimensional endoanal ultrasound and quality of life assessment. 7187/2020


Download to a citation manager

Download the citation for this article by clicking on one of the following citation managers:

Metrics
This article has received 1032 visits.
This article has been downloaded 145 times.

Statistics from Dimensions


Statistics from Plum Analytics

Publication history

Received: 25/04/2020

Accepted: 02/05/2020

Online First: 15/10/2020

Published: 10/11/2020

Article revision time: 3 days

Article Online First time: 173 days

Article editing time: 199 days


Share
This article hasn't been rated yet.
Reader rating:
Valora este artículo:




Asociación Española de Ecografía Digestiva Sociedad Española de Endoscopia Digestiva Sociedad Española de Patología Digestiva
The Spanish Journal of Gastroenterology is the official organ of the Sociedad Española de Patología Digestiva, the Sociedad Española de Endoscopia Digestiva and the Asociación Española de Ecografía Digestiva
Cookie policy Privacy Policy Legal Notice © Copyright 2023 y Creative Commons. The Spanish Journal of Gastroenterology