Document Detail


To LIFT or to Flap? Which Surgery to Perform Following Seton Insertion for High Anal Fistula?
MedLine Citation:
PMID:  23135586     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
BACKGROUND: : The ideal surgery following seton insertion for high anal fistulas remains debatable.
OBJECTIVE: : This study aimed to compare the success between the endorectal advancement flap and the ligation of intersphincteric fistula tract techniques as the definitive procedure following seton placement.
DESIGN: : This study is a retrospective review.
SETTINGS: : This study was conducted at the Division of Colorectal Surgery, University Surgical Cluster, National University Health System, Singapore, between April 2006 and July 2011.
PATIENTS AND INTERVENTIONS: : After seton placement for high anal fistulas, 31 and 24 patients underwent the endorectal advancement flap and the ligation of intersphincteric fistula tract procedures.
MAIN OUTCOME MEASURES: : Failure was defined as the nonhealing of the surgical wounds or persistent discharge at the external opening.
RESULTS: : We identified 31 patients with a median age of 49 (range, 19-74) years in the endorectal advancement flap group. The median interval from the seton procedure to the flap procedure was 13 (range, 4-284) weeks. Over a median follow up of 6 (range, 2-26) months, 29 (93.5%) patients had successful outcomes. There were 24 patients, median age 41 (range, 16-75) years, in the ligation of intersphincteric fistula tract group. The median interval from the seton placement to the definitive surgery was 14 (range, 8-74) weeks. Over a median follow-up of 13 (range, 4-67) months, 15 (62.5%) patients had successful outcomes. Hence when performed as the initial definitive procedure after a seton, the endorectal advancement flap technique had a significantly higher success rate in comparison with the ligation of intersphincteric fistula tract approach (93.5% vs 62.5%) (p = 0.006).
CONCLUSION: : In patients who have had seton placement for high anal fistulas, the endorectal advancement flap technique is associated with better short-term outcomes in comparison with the ligation of intersphincteric fistula tract technique.
Authors:
Ker-Kan Tan; Rayan Alsuwaigh; Aloysius M Tan; Ian J Tan; Xuandao Liu; Dean C Koh; Charles B Tsang
Related Documents :
20195866 - Rhinoplasty using nácul's suspensor system: a preliminary report.
24176806 - Unstaged versus staged posterior-only thoracolumbar fusions in deformity: a retrospecti...
12707196 - The presentation and management of nasal dermoid: a 30-year experience.
24032066 - Canada's first robotic-assisted totally intracorporeal orthotopic ileal neobladder.
21981376 - Patterns of trauma in conflict victims from timor leste.
18649096 - Does experience with laparoscopic colorectal surgery influence intraoperative outcomes?
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Diseases of the colon and rectum     Volume:  55     ISSN:  1530-0358     ISO Abbreviation:  Dis. Colon Rectum     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-11-08     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372764     Medline TA:  Dis Colon Rectum     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1273-7     Citation Subset:  IM    
Affiliation:
Division of Colorectal Surgery, University Surgical Cluster, National University Health System, Singapore.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Ileostomy pathway virtually eliminates readmissions for dehydration in new ostomates.
Next Document:  Neuromodulation for fecal and urinary incontinence: functional results in 57 consecutive patients f...