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- W4386104920 abstract "Abstract Background Horseshoe fistula remains a complex and challenging clinical entity due to the configuration, depth, degree of sphincter involvement and confusing anatomy of the fistula. Lack of recognition, high rates of recurrence after insufficient treatment and incontinence are the dominant issues surrounding the management of the disease. We provide a new technique, which is staged fistulotomy with rerouting of transsphincteric track into intersphincteric position and the newly positioned intersphincteric fistula is then dealt with at a later date when the wound related to the external sphincter is soundly healed, so we achieve the gold standard lay open of the fistula in addition to minimal sphincter sacrificing aiming to the least recurrence rate and avoiding functional complications as much as possible. Aim The aim was to describe the surgical technique that we use for the treatment of horseshoe perianal fistula and to study its effect on recurrence and continence. Patients and Methods A prospective study in which thirty patients to be operated upon was recruited from Ain Shams University Hospital & Dar Elshefa Hospital. Staged fistulotomy with rerouting of transsphincteric track of the fistula into intersphincteric position was done. The newly positioned intersphincteric fistula is then dealt with at a later date when the wound related to the external sphincter is soundly healed. Results 23 cases (76%) out of 30 cases to be operated upon underwent all stages of the procedure. As regard Patients underwent all stages of the procedure 20 cases (87%) developed no degree of incontinence 3 cases (13%) developed degree of incontinence (wexner score 2)(gas leak once a week). There were no cases of recurrence. Conclusion Staged fistulotomy for horseshoe fistula with rerouting of transsphincteric track into intersphincteric position was associated with no recurrence and accepted functional complications." @default.
- W4386104920 created "2023-08-24" @default.
- W4386104920 creator A5043722533 @default.
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- W4386104920 date "2023-06-01" @default.
- W4386104920 modified "2023-09-27" @default.
- W4386104920 title "Rerouting as a Sphincter Saving Procedure for Management of Horseshoe Perianal Fistula" @default.
- W4386104920 doi "https://doi.org/10.1093/qjmed/hcad069.328" @default.
- W4386104920 hasPublicationYear "2023" @default.
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