Erschienen in:
21.05.2018 | Trick of the Trade
A gastric feeding tube as a non-traumatic fistula probe during anal fistula repair
verfasst von:
T. Van den Broeck, C. de Gheldere
Erschienen in:
Techniques in Coloproctology
|
Ausgabe 5/2018
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Excerpt
Anal fistulas comprise a disease spectrum ranging from simple submucosal fistula tracts to extrasphincteric fistulas with multiple tracts. A large variety of treatment options exist for the diverse clinical presentations. The first surgical treatments used sacrificed the anal sphincter and are often associated with significant comorbidities such as high incontinence rates and alteration of anal sphincter anatomy [
1]. Therefore, more modern surgical approaches are focused on sparing the sphincter. These surgical treatments include closure of the fistula tract with plugs, fibrin glue or clips, and obliteration of the fistula tract with diathermy or with fistula tract laser closure (FiLaC™) [
2,
3]. FiLaC™ is one of the newest procedures designed to treat complex anal fistulas, sealing the fistula lumen by means of diode laser energy. Whether the internal orifice needs to be closed before FiLaC™ is performed remains unclear [
4,
5]. For this technique, the laser fiber is introduced into the fistula tract through the external orifice with a Seldinger maneuver until it reaches the internal orifice of the anal canal. When in place, the fiber is withdrawn at the speed of 1 mm/sec, homogeneously delivering laser energy 360° causing shrinkage of the tract around the fiber. …
