Skip to main content

Advertisement

SpringerLink
Log in

Controversies in Fistula in Ano

  • Case Report
  • Published:
Indian Journal of Surgery Aims and scope Submit manuscript

Abstract

Managing a complex fistula in ano can be a daunting task for most surgeons; largely due to the two major dreaded complications—recurrence & fecal incontinence. It is important to understand the anatomy of the anal sphincters & the aetiopathological process of the disease to provide better patient care. There are quite a few controversies associated with fistula in ano & its management, which compound the difficulty in treating fistula in ano. This article attempts to clear some of those major controversies.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig 2
Fig 3
Fig 4

Similar content being viewed by others

References

  1. Ommer A, Herold A, Berg E, Fürst A, Sailer M, Schiedeck T (2011) Cryptoglandular anal fistulas. Dtsch Arzteblatt Int 108(42):707–713. doi:10.3238/arztebl.2011.0707, Epub 2011 Oct 21

    Google Scholar 

  2. Toyonaga T, Matsushima M, Tanaka Y, Shimojima Y, Matsumura N, Kannyama H, Nozawa M, Hatakeyama T, Suzuki K, Yanagita K, Tanaka M (2007) Microbiological analysis and endoanal ultrasonography for diagnosis of anal fistula in acute anorectal sepsis. Int J Colorectal Dis 22(2):209–213, Epub 2006 Apr 7

    Article  PubMed  Google Scholar 

  3. Malik AI, Nelson RL, Tou S (2010) Incision and drainage of perianal abscess with or without treatment of anal fistula. Cochrane Database Syst Rev (7):CD006827

  4. Holzheimer RG, Siebeck M (2006) Treatment procedures for anal fistulous cryptoglandular abscess—how to get the best results. Eur J Med Res 11(12):501–515

    PubMed  CAS  Google Scholar 

  5. Toyonaga T, Matsushima M, Kiriu T, Sogawa N, Kanyama H, Matsumura N, Shimojima Y, Hatakeyama T, Tanaka Y, Suzuki K, Tanaka M (2007) Factors affecting continence after fistulotomy for intersphincteric fistula-in-ano. Int J Colorectal Dis 22(9):1071–1075, Epub 2007 Jan 30

    Article  PubMed  Google Scholar 

  6. Perez F, Arroyo A, Serrano P, Candela F, Perez MT, Calpena R (2006) Prospective clinical and manometric study of fistulotomy with primary sphincter reconstruction in the management of recurrent complex fistula-in-ano. Int J Colorectal Dis 21(6):522–526, Epub 2005 Oct 20

    Article  PubMed  Google Scholar 

  7. Champagne BJ, O’Connor LM, Ferguson M, Orangio GR, Schertzer ME, Armstrong DN (2006) Efficacy of anal fistula plug in closure of cryptoglandular fistulas: long-term follow-up. Dis Colon Rectum 49(12):1817–1821

    Article  PubMed  Google Scholar 

  8. Wang JY, Garcia-Aguilar J, Sternberg JA, Abel ME, Varma MG (2009) Treatment of transsphincteric anal fistulas: are fistula plugs an acceptable alternative? Dis Colon Rectum 52(4):692–697

    Article  PubMed  Google Scholar 

  9. Schwandner O, Stadler F, Dietl O, Wirsching RP, Fuerst A (2008) Initial experience on efficacy in closure of cryptoglandular and Crohn’s transsphincteric fistulas by the use of the anal fistula plug. Int J Colorectal Dis 23(3):319–324, Epub 2007 Nov 22

    Article  PubMed  CAS  Google Scholar 

  10. van Koperen PJ, Bemelman WA, Gerhards MF, Janssen LW, van Tets WF, van Dalsen AD, Slors JF (2011) The anal fistula plug treatment compared with the mucosal advancement flap for cryptoglandular high transsphincteric perianal fistula: a double-blinded multicenter randomized trial. Dis Colon Rectum 54(4):387–393

    Article  PubMed  Google Scholar 

  11. Lupinacci RM, Vallet C, Parc Y, Chafai N, Tiret E (2010) Treatment of fistula-in-ano with the Surgisis(®) AFP(TM) anal fistula plug. Gastroenterol Clin Biol 34(10):549–553, Epub 2010 Sep 6

    Article  PubMed  CAS  Google Scholar 

  12. McGee MF, Champagne BJ, Stulberg JJ, Reynolds H, Marderstein E, Delaney CP (2010) Tract length predicts successful closure with anal fistula plug in cryptoglandular fistulas. Dis Colon Rectum 53(8):1116–1120

    Article  PubMed  Google Scholar 

  13. Ratto C, Litta F, Parello A, Donisi L, Zaccone G, De Simone V (2012) Gore Bio-A(®) fistula plug, a new sphincter-sparing procedure for complex anal fistula. Colorectal Dis. doi:10.1111/j.1463-1318.2012.02964.x

  14. Han JG, Wang ZJ, Zhao BC, Zheng Y, Zhao B, Yi BQ, Yang XQ (2011) Long-term outcomes of human acellular dermal matrix plug in closure of complex anal fistulas with a single tract. Dis Colon Rectum 54(11):1412–1418

    Article  PubMed  Google Scholar 

  15. Buchberg B, Masoomi H, Choi J, Bergman H, Mills S, Stamos MJ (2010) A tale of two (anal fistula) plugs: is there a difference in short-term outcomes? Am Surg 76(10):1150–1153

    PubMed  Google Scholar 

  16. Lentner A, Wienert V (1996) Long-term, indwelling setons for low transsphincteric and intersphincteric anal fistulas. Experience with 108 cases. Dis Colon Rectum 39(10):1097–1101

    Article  PubMed  CAS  Google Scholar 

  17. Chuang-Wei C, Chang-Chieh W, Cheng-Wen H, Tsai-Yu L, Chun-Che F, Shu-Wen J (2008) Cutting seton for complex anal fistulas. Surgeon 6(3):185–188

    Article  PubMed  CAS  Google Scholar 

  18. Ritchie RD, Sackier JM, Hodde JP (2009) Incontinence rates after cutting seton treatment for anal fistula. Colorectal Dis 11(6):564–571, Epub 2008 Oct 17

    Article  PubMed  CAS  Google Scholar 

  19. Vial M, Parés D, Pera M, Grande L (2010) Faecal incontinence after seton treatment for anal fistulae with and without surgical division of internal anal sphincter: a systematic review. Colorectal Dis 12(3):172–178, Epub 2009 Feb 7

    Article  PubMed  CAS  Google Scholar 

  20. Galis-Rozen E, Tulchinsky H, Rosen A, Eldar S, Rabau M, Stepanski A, Klausner JM, Ziv Y (2010) Long-term outcome of loose seton for complex anal fistula: a two-centre study of patients with and without Crohn’s disease. Colorectal Dis 12(4):358–362, Epub 2009 Feb 7

    Article  PubMed  CAS  Google Scholar 

  21. Eitan A, Koliada M, Bickel A (2009) The use of the loose seton technique as a definitive treatment for recurrent and persistent high trans-sphincteric anal fistulas: a long-term outcome. J Gastrointest Surg 13(6):1116–1119, Epub 2009 Feb 24

    Article  PubMed  Google Scholar 

  22. Rojanasakul A, Pattanaarun J, Sahakitrungruang C, Tantiphlachiva K (2007) Total anal sphincter saving technique for fistula-in-ano; the ligation of intersphincteric fistula tract. J Med Assoc Thai 90(3):581–586

    PubMed  Google Scholar 

  23. Aboulian A, Kaji AH, Kumar RR (2011) Early result of ligation of the intersphincteric fistula tract for fistula-in-ano. Dis Colon Rectum 54(3):289–292

    Article  PubMed  Google Scholar 

  24. Shanwani A, Nor AM, Amri N (2010) Ligation of the intersphincteric fistula tract (LIFT): a sphincter-saving technique for fistula-in-ano. Dis Colon Rectum 53(1):39–42

    Article  PubMed  CAS  Google Scholar 

  25. Sileri P, Franceschilli L, Angelucci GP, D’Ugo S, Milito G, Cadeddu F, Selvaggio I, Lazzaro S, Gaspari AL (2011) Ligation of the intersphincteric fistula tract (LIFT) to treat anal fistula: early results from a prospective observational study. Tech Coloproctol 15(4):413–416, Epub 2011 Nov 11

    Article  PubMed  CAS  Google Scholar 

  26. Ooi K, Skinner I, Croxford M, Faragher I, McLaughlin S (2011) Managing fistula-in-ano with ligation of the intersphincteric fistula tract (LIFT) procedure: the Western Hospital experience. Colorectal Dis. doi:10.1111/j.1463-1318.2011.02723.x

  27. Jacob TJ, Perakath B, Keighley MR (2010) Surgical intervention for anorectal fistula. Cochrane Database Syst Rev (5):CD006319

Download references

Author information

Authors and Affiliations

  1. Saifee Hospital, Mumbai, India

    Parvez Sheikh

  2. Nova Specialty Center, Mumbai, India

    Parvez Sheikh

Authors
  1. Parvez Sheikh
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Parvez Sheikh.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Sheikh, P. Controversies in Fistula in Ano. Indian J Surg 74, 217–220 (2012). https://doi.org/10.1007/s12262-012-0594-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12262-012-0594-5

Keywords

Search

Navigation