Sphincter damage during fistulotomy for perianal fistulae and its relationship with faecal incontinence.

Abstract Background The length of sphincter which can be divided during fistulotomy for perianal fistula is unclear. The aim was to quantify sphincter damage during fistulotomy and determine the relationship between such damage with symptoms and severity of faecal incontinence and long-term quality of life (QOL). Methods A prospective cohort study was performed over a 2-year period. Patients with intersphincteric and mid to low transsphincteric perianal fistulas without risk factors for faecal incontinence were scheduled for fistulotomy. All patients underwent 3D endoanal ultrasound (3D-EAUS) pre-operatively and 8 weeks postoperatively. Measurements were taken of pre- and postoperative anal…

Utilidad de la ecografía endoanal tridimensional para el manejo y el diagnóstico de las fístulas perianales

Las fístulas perianales afectan alrededor de 10/100000 personas/años con un pico de incidencia entre la tercera y la quinta década de la vida. Las fístulas y los abscesos perianales representan estadios sucesivos de una misma enfermedad supurativa, siendo entre el 80-90% de origen criptoglandular. La clasificación de las fístulas perianales no siempre resulta sencilla. La más utilizada y conocida es la clasificación de Parks, la cual divide las fístulas en: interesfintéricas, transesfintéricas, supraesfintéricas y extraesfintéricas. Otras formas clásicas de clasificar las fístulas es en: simples y complejas (según la dificultad a la hora del manejo) o altas y bajas (según la altura a la que…

Rectal advancement flaps for the treatment of transphincteric perianal fistulas: a three-dimensional endoanal ultrasound and quality of life assessment.

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 …

Fe de errores de «Evaluación de las fístulas perianales mediante ecografía endoanal tridimensional y correlación con los hallazgos intraoperatorios»

[Evaluation of three-dimensional endoanal endosonography of perianal fistulas and correlation with surgical findings].

Abstract Objective This study aims to assess the accuracy of three-dimensional endoanal ultrasound (3D-US), two-dimensional ultrasound (2D-US) and physical examination (PE) for the diagnosis of perianal fistulas and correlate the results with intraoperative findings. Materials and methods A prospective, observational study with consecutive inclusion of patients was performed between December 2008 and August 2009. Twenty-nine patients diagnosed with a perianal fistula due to undergo surgery were included. All patients underwent PE, 2D-US and 3D-US, and the results were compared to intraoperative findings. The examinations were repeated with hydrogen peroxide instilled through the external op…

Evaluación de las fístulas perianales mediante ecografía endoanal tridimensional y correlación con los hallazgos intraoperatorios

Resumen Objetivo Evaluar la fiabilidad diagnostica de la ecografia tridimensional (ECO 3D) vs. la bidimensional (ECO 2D) y la exploracion fisica en el diagnostico de las fistulas perianales correlacionandolo con los hallazgos intraoperatorios. Material y metodo Estudio prospectivo, observacional con pacientes incluidos de forma consecutiva entre diciembre 2008 y agosto 2009. Se incluyen 29 pacientes diagnosticados de fistula perianal subsidiarios de tratamiento quirurgico. Se realizo una exploracion fisica, ECO 2D, ECO 3D comparandolos con los hallazgos intraoperatorios. Cuando el orificio fistuloso externo se encuentra abierto, se repiten ambas exploraciones instilando agua oxigenada. Resu…