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https://doi.org/10.1097/DCR.0b013e31822bb55e
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dc.title | The anatomy of failures following the ligation of intersphincteric tract technique for anal fistula: A review of 93 patients over 4 years | |
dc.contributor.author | Tan, K.-K. | |
dc.contributor.author | Tan, I.J. | |
dc.contributor.author | Lim, F.S. | |
dc.contributor.author | Koh, D.C. | |
dc.contributor.author | Tsang, C.B. | |
dc.date.accessioned | 2016-07-10T02:36:55Z | |
dc.date.available | 2016-07-10T02:36:55Z | |
dc.date.issued | 2011-11 | |
dc.identifier.citation | Tan, K.-K., Tan, I.J., Lim, F.S., Koh, D.C., Tsang, C.B. (2011-11). The anatomy of failures following the ligation of intersphincteric tract technique for anal fistula: A review of 93 patients over 4 years. Diseases of the Colon and Rectum 54 (11) : 1368-1372. ScholarBank@NUS Repository. https://doi.org/10.1097/DCR.0b013e31822bb55e | |
dc.identifier.issn | 00123706 | |
dc.identifier.uri | http://scholarbank.nus.edu.sg/handle/10635/125905 | |
dc.description.abstract | BACKGROUND: Although the ligation of intersphincteric tract technique is a promising sphincter-preserving option in managing anal fistulas, failures are still seen. OBJECTIVE: This study aimed to illustrate the patterns of failures and recurrences following the ligation of intersphincteric tract procedure for anal fistulas. 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, from April 2006 to September 2010. PATIENTS: Ninety-three patients were evaluated. INTERVENTIONS: All patients underwent the ligation of intersphincteric tract procedure for anal fistulas. MAIN OUTCOME MEASURES: Failure was defined as nonhealing of the surgical wound or fistula. Recurrence was defined as the reappearance of the fistula after initial healing. RESULTS: After a median follow-up of 23 (range, 1-85) weeks, there were 7 failures and 6 recurrences. The median time to healing was 4 (range, 1-12) weeks. The freedom from failure or recurrence at 1 year following the ligation of intersphincteric tract procedure was 78% (95% CI: 66%-90%). All 7 failures had discharge at the intersphincteric wound. Four had an unhealed internal opening, and 3 had isolated failures at the intersphincteric wound. Endoanal ultrasonography revealed a less complicated anatomy that enabled successful treatment with either local application of silver nitrate (n = 3) or fistulotomy (n = 4). All 6 recurrences had a demonstrable tract from the previous internal opening to an external opening with healing of the intersphincteric wound. The median time to recurrence was 22 (range, 15-33) weeks from the ligation of the intersphincteric tract procedure. Fistulotomy, repeat ligation of intersphincteric tract, or anocutaneous advancement flap procedure was successfully performed subsequently. CONCLUSION: In patients with early failures, the medialization of the external opening to the intersphincteric wound simplified subsequent management. All recurrences should be reevaluated and managed accordingly. © The ASCRS 2011. | |
dc.description.uri | http://libproxy1.nus.edu.sg/login?url=http://dx.doi.org/10.1097/DCR.0b013e31822bb55e | |
dc.source | Scopus | |
dc.subject | Anal fistula | |
dc.subject | Classification | |
dc.subject | Failure | |
dc.subject | LIFT | |
dc.type | Review | |
dc.contributor.department | SURGERY | |
dc.description.doi | 10.1097/DCR.0b013e31822bb55e | |
dc.description.sourcetitle | Diseases of the Colon and Rectum | |
dc.description.volume | 54 | |
dc.description.issue | 11 | |
dc.description.page | 1368-1372 | |
dc.description.coden | DICRA | |
dc.identifier.isiut | 000295878800006 | |
Appears in Collections: | Staff Publications |
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