Endorectal Advancement Flap With Muscular Plication in Anovaginal and Anterior Perineal Fistulas
Purpose Endorectal mucosal advancement flap with muscular plication can ensure complete closure of anovaginal fistulas and preserve continence. The aim of this retrospective study was to show indications might be broadened to include anoperineal fistulas. Methods This retrospective study gathered al...
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| Format: | Article |
| Language: | English |
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Korean Society of Coloproctology
2021-06-01
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| Series: | Annals of Coloproctology |
| Subjects: | |
| Online Access: | http://coloproctol.org/upload/pdf/ac-2020-04-10-1.pdf |
| _version_ | 1819284634796556288 |
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| author | Axel Egal Isabelle Etienney Patrick Atienza |
| author_facet | Axel Egal Isabelle Etienney Patrick Atienza |
| author_sort | Axel Egal |
| collection | DOAJ |
| description | Purpose Endorectal mucosal advancement flap with muscular plication can ensure complete closure of anovaginal fistulas and preserve continence. The aim of this retrospective study was to show indications might be broadened to include anoperineal fistulas. Methods This retrospective study gathered all available data from patients with anovaginal or anterior perineal fistulas who underwent transanal advancement flap repair with muscular plication. A loose seton was passed in the fistula track prior to surgery in all patients. Fistula healing was defined as fistula closure during proctological examination associated with complete resolution of symptoms. Results Thirty-five patients were included from January 2011 to March 2017. Causes of fistula were various, mostly post-operative (34.3%, n = 12), obstetrical (17.1%, n = 6) and inflammatory (14.3%, n = 5). Success rate was 65.2%. Fistula healing was obtained in 60.0% of patients with Crohn disease in remission. Closure rate was higher in anterior perineal fistulas (89.0%) than in anovaginal fistulas (63.6%) even if it did not reach statistical significance. Slight fecal continence disorders were noted in 2 women (5.7%). Conclusion This study demonstrates the efficacy of transanal advancement flap repair with muscular plication for anovaginal and anterior perineal fistulas. Similar closure rates and smaller postoperative incontinence rates compared to the classical technique make this surgery an optimal solution whose efficacy appears to be sustainable over time. |
| first_indexed | 2024-12-24T01:50:30Z |
| format | Article |
| id | doaj.art-e32cc8d906774d60b38a8d9a26d6644b |
| institution | Directory Open Access Journal |
| issn | 2287-9714 2287-9722 |
| language | English |
| last_indexed | 2024-12-24T01:50:30Z |
| publishDate | 2021-06-01 |
| publisher | Korean Society of Coloproctology |
| record_format | Article |
| series | Annals of Coloproctology |
| spelling | doaj.art-e32cc8d906774d60b38a8d9a26d6644b2022-12-21T17:21:45ZengKorean Society of ColoproctologyAnnals of Coloproctology2287-97142287-97222021-06-0137314114510.3393/ac.2020.04.10.11727Endorectal Advancement Flap With Muscular Plication in Anovaginal and Anterior Perineal FistulasAxel EgalIsabelle Etienney0Patrick Atienza1 Department of Proctology, Groupe Hospitalier Diaconesses Croix Saint-Simon, Paris, France Department of Proctology, Groupe Hospitalier Diaconesses Croix Saint-Simon, Paris, FrancePurpose Endorectal mucosal advancement flap with muscular plication can ensure complete closure of anovaginal fistulas and preserve continence. The aim of this retrospective study was to show indications might be broadened to include anoperineal fistulas. Methods This retrospective study gathered all available data from patients with anovaginal or anterior perineal fistulas who underwent transanal advancement flap repair with muscular plication. A loose seton was passed in the fistula track prior to surgery in all patients. Fistula healing was defined as fistula closure during proctological examination associated with complete resolution of symptoms. Results Thirty-five patients were included from January 2011 to March 2017. Causes of fistula were various, mostly post-operative (34.3%, n = 12), obstetrical (17.1%, n = 6) and inflammatory (14.3%, n = 5). Success rate was 65.2%. Fistula healing was obtained in 60.0% of patients with Crohn disease in remission. Closure rate was higher in anterior perineal fistulas (89.0%) than in anovaginal fistulas (63.6%) even if it did not reach statistical significance. Slight fecal continence disorders were noted in 2 women (5.7%). Conclusion This study demonstrates the efficacy of transanal advancement flap repair with muscular plication for anovaginal and anterior perineal fistulas. Similar closure rates and smaller postoperative incontinence rates compared to the classical technique make this surgery an optimal solution whose efficacy appears to be sustainable over time.http://coloproctol.org/upload/pdf/ac-2020-04-10-1.pdfrectovaginal fistulaanovaginal fistulaendorectal advancement flapmuscular plicationanal continence |
| spellingShingle | Axel Egal Isabelle Etienney Patrick Atienza Endorectal Advancement Flap With Muscular Plication in Anovaginal and Anterior Perineal Fistulas Annals of Coloproctology rectovaginal fistula anovaginal fistula endorectal advancement flap muscular plication anal continence |
| title | Endorectal Advancement Flap With Muscular Plication in Anovaginal and Anterior Perineal Fistulas |
| title_full | Endorectal Advancement Flap With Muscular Plication in Anovaginal and Anterior Perineal Fistulas |
| title_fullStr | Endorectal Advancement Flap With Muscular Plication in Anovaginal and Anterior Perineal Fistulas |
| title_full_unstemmed | Endorectal Advancement Flap With Muscular Plication in Anovaginal and Anterior Perineal Fistulas |
| title_short | Endorectal Advancement Flap With Muscular Plication in Anovaginal and Anterior Perineal Fistulas |
| title_sort | endorectal advancement flap with muscular plication in anovaginal and anterior perineal fistulas |
| topic | rectovaginal fistula anovaginal fistula endorectal advancement flap muscular plication anal continence |
| url | http://coloproctol.org/upload/pdf/ac-2020-04-10-1.pdf |
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