| Does rectal mucosal blood flow affect the outcome of transanal advancement flap repair? | |
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MedLine Citation:
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PMID: 19617750 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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INTRODUCTION: Transanal advancement flap repair provides a useful tool for the treatment of high transsphincteric fistulas. Recent studies indicate that transanal advancement flap repair fails in one of every three patients. Until now no definite risk factors for failure have been identified. A previous pilot study, conducted in our own institution, revealed a significant decrease in rectal mucosal blood flow after creation of the advancement flap. We postulated that impaired blood flow might result in breakdown of the distal part of the flap. This study was designed to evaluate the effect of rectal mucosal blood flow on the outcome of transanal advancement flap repair. METHODS: Between August 2004 and June 2007 a series of 54 patients with a high transsphincteric fistula underwent transanal advancement flap repair. The present series comprised 34 males and 20 females. Median age at the time of repair was 45 (range, 25-68) years. Rectal mucosal blood flow was determined by laser Doppler flowmetry before and after creation of the flap. The flow was expressed in arbitrary units. RESULTS: Transanal advancement flap repair was successful in 34 patients (63%). Median healing time was 2.2 months. Median mucosal blood flow before and after transanal advancement flap repair was 145 arbitrary units and 94 arbitrary units, respectively. This decrease was statistically significant. In a comparison of patients with and patients without a successful repair, no differences were found in mucosal blood flow before and after creation of the flap (146 vs. 138 arbitrary units and 83 vs. 104 arbitrary units). CONCLUSION: Rectal mucosal blood flow does not affect the outcome of transanal advancement flap repair. |
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Authors:
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Litza E Mitalas; Sander B Schouten; Martijn P Gosselink; Daniella M J Oom; David D E Zimmerman; W Rudolph Schouten |
Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: Diseases of the colon and rectum Volume: 52 ISSN: 1530-0358 ISO Abbreviation: Dis. Colon Rectum Publication Date: 2009 Aug |
Date Detail:
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Created Date: 2009-07-20 Completed Date: 2009-08-06 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0372764 Medline TA: Dis Colon Rectum Country: United States |
Other Details:
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Languages: eng Pagination: 1395-9 Citation Subset: IM |
Affiliation:
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Department of Surgery, Erasmus Medical Center, Rotterdam, The Netherlands. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Digestive System Surgical Procedures / methods* Female Follow-Up Studies Humans Intestinal Mucosa / blood supply* Laser-Doppler Flowmetry Male Middle Aged Rectal Fistula / surgery* Regional Blood Flow Retrospective Studies Surgical Flaps / blood supply* Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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