INTRODUCTION: Management of fistula-in-ano requires understanding of both perianal and rectal anatomy, as well as the surgical approaches available to ensure the highest possible postoperative continence and wound healing. Further, high rates of recurrence with medical management commonly bring these patients under the care of the colorectal surgeon after variable periods of failed conservative management. Novel techniques provide surgeons with tools to treat increasingly complex fistulas with a focus on maintaining sphincteric functionality and limiting recurrence. METHOD: This manuscript presents our practice, including perioperative decision making regarding surgical approach, in managing patients with fistula-in-ano. CONCLUSION: Familiarity with these techniques prepares the general surgeon and colorectal surgeon to improve wound healing and functional outcomes in these patients, especially with complex disease involving the external and internal anal sphincters.
INTRODUCTION: Management of fistula-in-ano requires understanding of both perianal and rectal anatomy, as well as the surgical approaches available to ensure the highest possible postoperative continence and wound healing. Further, high rates of recurrence with medical management commonly bring these patients under the care of the colorectal surgeon after variable periods of failed conservative management. Novel techniques provide surgeons with tools to treat increasingly complex fistulas with a focus on maintaining sphincteric functionality and limiting recurrence. METHOD: This manuscript presents our practice, including perioperative decision making regarding surgical approach, in managing patients with fistula-in-ano. CONCLUSION: Familiarity with these techniques prepares the general surgeon and colorectal surgeon to improve wound healing and functional outcomes in these patients, especially with complex disease involving the external and internal anal sphincters.
Authors: R L West; D D E Zimmerman; S Dwarkasing; S M Hussain; W C J Hop; W R Schouten; E J Kuipers; R J F Felt-Bersma Journal: Dis Colon Rectum Date: 2003-10 Impact factor: 4.585
Authors: Joseph W Nunoo-Mensah; Swarna Balasubramaniam; Nir Wasserberg; Avo Artinyan; Claudia Gonzalez-Ruiz; Andreas M Kaiser; Robert W Beart; Petar Vukasin Journal: Int J Colorectal Dis Date: 2005-08-10 Impact factor: 2.571
Authors: Mark H Whiteford; John Kilkenny; Neil Hyman; W Donald Buie; Jeffrey Cohen; Charles Orsay; Gary Dunn; W Brian Perry; C Neal Ellis; Jan Rakinic; Sharon Gregorcyk; Paul Shellito; Richard Nelson; Joe J Tjandra; Graham Newstead Journal: Dis Colon Rectum Date: 2005-07 Impact factor: 4.585