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 %).
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15/11/2023 20:37:50
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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.
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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


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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


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