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Techniques in Coloproctology
Erschienen in: Techniques in Coloproctology 10/2015

01.10.2015 | Clinical Guidelines

Evaluation and management of perianal abscess and anal fistula: a consensus statement developed by the Italian Society of Colorectal Surgery (SICCR)

verfasst von: A. Amato, C. Bottini, P. De Nardi, P. Giamundo, A. Lauretta, A. Realis Luc, G. Tegon, R. J. Nicholls

Erschienen in: Techniques in Coloproctology | Ausgabe 10/2015

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Abstract

Perianal sepsis is a common condition ranging from acute abscess to chronic fistula formation. In most cases, the source is considered to be a non-specific cryptoglandular infection starting from the intersphincteric space. The key to successful treatment is the eradication of the primary track. As surgery may lead to a disturbance of continence, several sphincter-preserving techniques have been developed. This consensus statement examines the pertinent literature and provides evidence-based recommendations to improve individualized management of patients.
Literatur
1.
Eisenhammer S (1954) Advances in anorectal surgery with special reference to ambulatory treatment. S Afr Med J 28:264PubMed
2.
Goligher JC, Ellis M, Pissidis AG (1967) A critique of anal glandular infection in the aetiology and treatment of idiopathic anorectal abscesses and fistulas. Br J Surg 54:977–983PubMedCrossRef
3.
Lunniss PJ, Phillips RKS (1994) Surgical assessment of acute anorectal sepsis is a better predictor of fistula than microbiological analysis. Br J Surg 81:368–369PubMedCrossRef
4.
Parks AG (1961) Pathogenesis and treatment of fistula-in-ano. Br Med J 18:463–469CrossRef
5.
Williams JG, Farrands PA, Williams AB et al (2007) The treatment of anal fistula: ACPGBI Position Statement. Colorectal Dis 9:18–50PubMedCrossRef
6.
Lillius HG (1968) An investigation on human foetal anal ducts and intramuscular glands: a clinical study of 150 patients. Acta Chir Scan 383:7–88
7.
Abeysuriya V, Salgado LS, Samarasekera DN (2010) The distribution of the anal glands and the variable regional occurrence of fistula-in-ano: is there a relationship? Tech Coloproctol 14:317–321PubMedCrossRef
8.
Marks CG, Ritchie JK, Lockhart-Mummery HE (1981) Anal fistulas in Crohn’s disease. Br J Surg 68:525–527PubMedCrossRef
9.
Culp CE (1983) Chronic hidradenitis of the anal canal: a surgical skin disease. Dis Colon Rectum 26:669–676PubMedCrossRef
10.
Shukla HS, Gupta SC, Singh G, Singh PA (1988) Tubercular fistula in ano. Br J Surg 75:38–39PubMedCrossRef
11.
Eisenhammer S (1956) The internal anal sphincter and the anorectal abscess. Surg Gynecol Obstet 103:501–506PubMed
12.
13.
Sneider EB, Maykel JA (2013) Anal abscess and fistula. Gastroenterol Clin N Am 42:773–784CrossRef
14.
Zanotti C, Martinez-Puente C, Pascual I, Pascual M, Herreros D, Garcia-Olmo D (2007) An assessment of the incidence of fistula-in-ano in four countries of the European Union. Int J Color Dis 22:1459–1462CrossRef
15.
Sainio P (1984) Fistula-in-ano in a defined population. Incidence and epidemiological aspects. Ann Chir Gynaecol 73:219–224PubMed
16.
Hamalainen KP, Sainio AP (1998) Incidence of fistulas after drainage of acute anorectal abscesses. Dis Colon Rectum 41:1357–1361PubMedCrossRef
17.
Parks AG, Gordon PH, Hardcastle JD (1976) A classification of fistula-in-ano. Br J Surg 63:1–12PubMedCrossRef
18.
Fazio VW (1987) Complex anal fistulae. Gastroenterol Clin North Am 16:93–114PubMed
19.
Guyatt G, Gutterman D, Baumann MH et al (2006) Grading strength of recommendations and quality of evidence in clinical guidelines: report from an American College of Chest Physicians Task Force. Chest 129:174–181PubMedCrossRef
20.
21.
Goldberg SM, Gordon PH, Nivatvongs S (1980) Essential of anorectal surgery. JB Lippincott, Philadelphia, pp 100–127
22.
Nelson J, Billingham R (2007) Pilonidal disease and hidradenitis suppurativa. In: Wollf BG, Fleshman JW, Beck DE et al (eds) The ASCRS textbook of colon and rectal surgery. Springer, New York, pp 228–235CrossRef
23.
Goodsall DH, Miles WE (1982) Anorectal fistula. Dis Colon Rectum 25:262–278CrossRef
24.
Cirocco WC, Reilly JC (1992) Challenging the predictive accuracy of Goodsall’s rule for anal fistulas. Dis Colon Rectum 35:537–542PubMedCrossRef
25.
Gunawardhana PA, Keen DI (2001) Comparison of hydrogen peroxide instillation with Goodsall’s rule for fistula-in-ano. Aust NZ J Surg 71:472–474CrossRef
26.
Kuijpers HC, Schulpen T (1985) Fistulography for fistula-in-ano: is it useful? Dis Colon Rectum 28:103–104PubMedCrossRef
27.
Toyonaga T, Tanaga Y, Song JF et al (2008) Comparison of accuracy of physical examination and endoanal ultrasonography for preoperative assessment in patients with acute and chronic anal fistula. Tech Coloproctol 12:217–223PubMedCrossRef
28.
Buchanan GN, Halligan S, Bartram CI, Williams AB, Tarroni D, Cohen CR (2004) Clinical examination, endosonography, and MR imaging in preoperative assessment of fistula in ano: comparison with outcome-based reference standard. Radiology 233:674–681PubMedCrossRef
29.
Benjelloun EB, Souiki TE, El Abkari M (2014) Endoanal ultrasound in anal fistulas. Is there any influence on postoperative outcome? Tech Coloproctol 18:405–406PubMedCrossRef
30.
Poen AC, Felt-Bersma RJ, Eijsbouts QA, Cuesta MA, Meuwissen SG (1998) Hydrogen peroxide enhanced transanal ultrasound in the assessment of fistula-in-ano. Dis Colon Rectum 41:1147–1152PubMedCrossRef
31.
Ratto C, Grillo E, Parello A (2005) Endoanal ultrasound-guided surgery for anal fistula. Endoscopy 37:722–728PubMedCrossRef
32.
Sudol-Szopinska I, Jakubowski W, Szczepkowski M (2002) Contrast-enhanced endosonography for the diagnosis of anal and anovaginal fistula. J Clin Ultrasound 30:145–150PubMedCrossRef
33.
Nagendranath C, Saravan N, Sridhar C, Varughese M (2014) Peroxide-enhanced endoanal ultrasound in preoperative assessment of complex fistula in ano. Tech Coloproctol 18:433–438PubMedCrossRef
34.
Santoro GA, Fortling B (2007) The advantages of volume rendering in three-dimensional endosonography of the anorectum. Dis Colon Rectum 50:359–368PubMedCrossRef
35.
West RL, Dwarkasing S, Felt-Bersma RJ, Schouten WR, Hop WC, Hussain SM, Kuipers EJ (2004) Hydrogen peroxide-enhanced three-dimensional endoanal ultrasonography and endoanal magnetic resonance imaging in evaluating perianal fistulas: agreement and patient preference. Eur J Gastroenterol Hepatol 16:1319–1324PubMedCrossRef
36.
Choen S, Burnett S, Bartram CI, Nicholls RJ (1991) Comparison between anal endosonography and digital examination in the evaluation of anal fistulae. Br J Surg 78:445–447PubMedCrossRef
37.
Guillaumin E, Jeffrey RB Jr, Hea WJ, Asling CW, Goldberg HI (1986) Perirectal inflammatory disease CT findings. Radiology 161:153–157PubMedCrossRef
38.
39.
Schaefer O, Lohrmann C, Langer M (2004) Assessment of anal fistulas with high-resolution subtraction MR-fistulography: comparison with surgical findings. J Magn Reson Imaging 19:91–98PubMedCrossRef
40.
Santoro GA, Di Falco G (2006) Endoanal ultrasonography in the evaluation of perianal sepsis and fistula in ano. In: Benign anorectal conditions. Springer, Italia pp 131–139
41.
Siddiqui MR, Ashrafian H, Tozer P et al (2012) A diagnostic accuracy meta-analysis of endoanal ultrasound and MRI for perianal fistula assessment. Dis Colon Rectum 55:576–585PubMedCrossRef
42.
Chapple KS, Spencer JA, Windsor AC, Wilson D, Ward J, Ambrose NS (2000) Prognostic value of magnetic resonance imaging in the management of fistula-in-ano. Dis Colon Rectum 43:511–516PubMedCrossRef
43.
Pescatori M, Ayabaca S, Caputo D (2004) Can anal manometry predict anal incontinence after fistulectomy in males? Colorectal Dis 6:97–102PubMedCrossRef
44.
Sainio P (1985) A manometric study of anorectal function after surgery for anal fistula, with special reference to incontinence. Acta Chir Scand 151:695–700PubMed
45.
Pescatori M, Maria G, Anastasio G, Rinallo L (1989) Anal manometry improves the outcome of surgery for fistula-in-ano. Dis Colon Rectum 32:588–592PubMedCrossRef
46.
Luchtefeld MA (2001) Anorectal abscess and fistula-in-ano. Clin Colon Rectal Surg 14:221–231CrossRef
47.
Senéjoux A, Siproudhis L (2013) «B.A.-BA SANS EBM…» du traitement des abcès et des fistules anales: 10 questions basiques (… ou à se poser fréquemment). Dis Colon Rectum 7:205–208CrossRef
48.
Buyukasik Y, Ozcebe OI, Sayinalp N et al (1998) Perianal infections in patients with leukemia: importance of the course of neutrophil count. Dis Colon Rectum 41:81–85PubMedCrossRef
49.
Cohen JS, Paz IB, O’Donnell MR, Ellenhorn JD (1996) Treatment of perianal infection following bone marrow transplantation. Dis Colon Rectum 39:981–985PubMedCrossRef
50.
Wilson W, Taubert KA, Gewitz T et al (2007) Prevention of Infective Endocarditis. Guidelines From the American Heart Association: A Guideline From the American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee, Council on Cardiovascular Disease in the Young, and the Council on Clinical Cardiology, Council on Cardiovascular Surgery and Anesthesia, and the Quality of Care and Outcomes Research Interdisciplinary Working Group. Circulation 16:1736–1754CrossRef
51.
RamanujamPS Prasad ML, Abcarian H, Tan AB (1984) Perianal abscess and fistulas. Dis Colon Rectum 27:593–597CrossRef
52.
53.
Onaca N, Hirshberg A, Adar R (2001) Early reoperation for perirectal abscess: a preventable complication. Dis Colon Rectum 44:1469–1473PubMedCrossRef
54.
Held D, Khubchandani I, Sheets J, Stasik J, Rosen L, Riether R (1986) Management of anorectal horseshoe abscess and fistula. Dis Colon Rectum 29:793–797PubMedCrossRef
55.
Malik AI, Nelson RL, Tou S (2010) Incision and drainage of perianal abscess with or without treatment of anal fistula. Cochrane Database Syst Rev 7:CD006827PubMed
56.
Quah HM, Tang CL, Eu KW, Chan SY, Samuel M (2005) Meta-analysis of randomized clinical trials comparing drainage alone vs primary sphincter-cutting procedures for anorectal abscess-fistula. Int J Colorectal Dis 30:1–8
57.
Tan KK, Liu X, Tsang CB, Koh DC (2012) Identification of the internal anal opening and seton placement improves the outcome of deep postanal space abcess. Colorectal Dis 15:598–601CrossRef
58.
Schouten WR, van Vroonhoven TJ (1991) Treatment of anorectal abscess with or without primary fistulectomy. Results of a prospective randomized trial. Dis Colon Rectum 34:60–63PubMedCrossRef
59.
Cox SW, Senagore AJ, Luchtefeld MA, Mazier WP (1997) Outcome after incision and drainage with fistulotomy for ischiorectal abscess. Am Surg 63:686–689PubMed
60.
Davies M, Harris D, Lohana P et al (2008) The surgical management of fistula-in-ano in a specialist colorectal unit. Int J Colorectal Dis 23:833–838PubMedCrossRef
61.
Ho KS, Tsang C, Seow-Choen F, Tang CL, Heah SM, Eu KW (2001) Prospective randomized trial comparing ayurvedic cutting seton and fistulotomy for low fistula-in-ano. Tech Coloproctol 5:137–141PubMedCrossRef
62.
Westerterp M, Volkers NA, Poolman RW, van Tets WF (2003) Anal fistulotomy between Scylla and Charybdis. Colorectal Dis 5:549–551PubMedCrossRef
63.
Jordán J, Roig JV, García-Armengol J, García-Granero E, Solana A, Lledó S (2010) Risk factors for recurrence and incontinence after anal fistula surgery. Colorectal Dis 12:254–260PubMedCrossRef
64.
Garcia-Aguilar J, Belmonte C, Wong WD, Goldberg SM, Madoff RD (1996) Anal fistula surgery. Factors associated with recurrence and incontinence. Dis Colon Rectum 39:723–729PubMedCrossRef
65.
Chang SC, Lin JK (2003) Change in anal continence after surgery for intersphincteral anal fistula: a functional and manometric study. Int J Colorectal Dis 18:111–115PubMedCrossRef
66.
Cavanaugh M, Hyman N, Osler T (2002) Fecal incontinence severity index after fistulotomy: a predictor of quality of life. Dis Colon Rectum 45:349–353PubMedCrossRef
67.
Buchanan GN, Williams AB, Bartram CI, Halligan S, Nicholls RJ, Cohen CR (2003) Potential clinical implications of direction of a trans-sphincteric anal fistula track. Br J Surg 90:1250–1255PubMedCrossRef
68.
Gupta PJ (2003) Radiosurgical fistulotomy; an alternative to conventional procedure in fistula in ano. Curr Surg 60:524–528PubMedCrossRef
69.
70.
Filingeri V, Gravante G, Baldessari E, Casciani CU (2004) Radiofrequency fistulectomy vs. diathermic fistulotomy for submucosal fistulas: a randomized trial. Eur Rev Med Pharmacol Sci 8:111–116PubMed
71.
Jacob TJ, Perakath B, Keighley MR (2010) Surgical intervention for anorectal fistula. Cochrane Database Syst Rev 12:CD006319
72.
Ho YH, Tan M, Leong AF, Seow-Choen F (1998) Marsupialization of fistulotomy wounds improves healing: a randomized controlled trial. Br J Surg 85:105–107PubMedCrossRef
73.
Pescatori M, Ayabaca SM, Cafaro D, Iannello A, Magrini S (2006) Marsupialization of fistulotomy and fistulectomy wounds improves healing and decreases bleeding: a randomized controlled trial. Colorectal Dis 8:11–14PubMedCrossRef
74.
Lentner A, Wienert V (1996) Long-term, indwelling setons for low transsphincteric and intersphincteric anal fistulas. Experience with 108 cases. Dis Colon Rectum 39:1097–1101PubMedCrossRef
75.
Ho KS, Tsang C, Seow-Choen F, Tang CL, Heah SM, Eu KW (2001) Prospective randomized trial comparing ayurvedic cutting seton and fistulotomy for low fistula-in-ano. Tech Coloproctol 5:137–141PubMedCrossRef
76.
Indian Council of Medical Research (1991) Multicentric randomized controlled clinical trial of Kshaarasootra (Ayurvedic medicated thread) in the management of fistula-in-ano. Indian J Med Res 94:177–185
77.
Kronborg O (1985) To lay open or excise a fistula-in-ano: a randomized trial. Br J Surg 72:970PubMedCrossRef
78.
Belmonte Montes C, Ruiz Galindo GH, Montes Villalobos JL, Decanini Terán C (1999) Fistulotomy vs. fistulectomy. Ultrasonographic evaluation of lesion of the anal sphincter function. Rev Gastroenterol Mex 64:167–170PubMed
79.
Steele SR, Kumar R, Feingold DL, Rafferty JL, Buie WD (2011) Practice parameters for the management of perianal abscess and fistula-in-ano. Dis Colon Rectum 54:1465–1474PubMedCrossRef
80.
Swinscoe MT, Ventakasubramaniam AK, Jayne DG (2005) Fibrin glue for fistula-in-ano: the evidence reviewed. Tech Coloproctol 9:89–94PubMedCrossRef
81.
Lindsey I, Smilgin-Humphreys MM, Cunningham C, Mortensen NJ, George BD (2002) A randomized, controlled trial of fibrin glue vs. conventional treatment for anal fistula. Dis Colon Rectum 45:1608–1615PubMedCrossRef
82.
Ozuner G, Hull TL, Cartmill J, Fazio VW (1996) Long-term analysis of the use of transanal rectal advancement flaps for complicated anorectal/vaginal fistulas. Dis Colon Rectum 39:10–14PubMedCrossRef
83.
Ortiiz H, Marzo M, de Miguel M, Ciga MA, Oteiza F, Armendariz P (2008) Length of follow-up after fistulotomy and fistulectomy associated with endorectal advancement flap repair for fistula in ano. Br J Surg 95:484–487CrossRef
84.
Mizrahi N, Wexner SD, Zmora O et al (2002) Endorectal advancement flap: are there predictors of failure? Dis Colon Rectum 45:1616–1621PubMedCrossRef
85.
Abbas MA, Lemus-Rangel R, Hamadani A (2008) Long-term outcome of endorectal advancement flap for complex anorectal fistulae. Am Surg 74:921–924PubMed
86.
Dubsky PC, Stift A, Friedl J, Teleky B, Herbst F (2008) Endorectal advancement flaps in the treatment of high anal fistula of cryptoglandular origin: full-thickness vs. mucosal-rectum flaps. Dis Colon Rectum 51:852–857PubMedCrossRef
87.
van Okelen RS, Gosselink MP, Thijsse S, Schouten WR (2014) Predictors of outcome after transanal advancement flap repair for high transsphincteric fistulas. Dis Colon Rectum 57:1007–1011CrossRef
88.
Ellis CN, Clark S (2006) Fibrin glue as an adjunct to flap repair of anal fistulas: a randomized, controlled study. Dis Colon Rectum 49:1736–1740PubMedCrossRef
89.
Uribe N, Millán M, Minguez M et al (2007) Clinical and manometric results of endorectal advancement flaps for complex anal fistula. Int J Colorectal Dis 22:259–264PubMedCrossRef
90.
Schouten WR, Zimmerman DD, Briel JW (1999) Transanal advancement flap repair of transsphincteric fistulas. Dis Colon Rectum 42:1419–1422PubMedCrossRef
91.
Athanasiadis S, Helmes C, Yazigi R, Kohler A (2004) The direct closure of the internal fistula opening without advancement flap for transsphincteric fistulas-in-ano. Dis Colon Rectum 47:1174–1180PubMedCrossRef
92.
Perez F, Arroyo A, Serrano P et al (2006) Randomized clinical and manometric study of advancement flap versus fistulotomy with sphincter reconstruction in the management of complex fistula-in-ano. Am J Surg 192:34–40PubMedCrossRef
93.
Van Koperen PJ, Wind J, Bemelman WA, Bakx R, Reitsma JB, Slors JF (2008) Long-term functional outcome and risk factors for recurrence after surgical treatment for low and high perianal fistulas of cryptoglandular origin. Dis Colon Rectum 51:1475–1481PubMedCrossRef
94.
Vasilevsky CA, Gordon PH (2007) Benign anorectal: abscess and fistula. In: Wolff BG, Fleshman JW, Beck DE, Pemberton JH, Wexner SD (eds) The ASCRS textbook of colon and rectal surgery. Springer, New York, pp 192–214
95.
Tyler KM, Aarons CB, Sentovich SM (2007) Successful sphincter-sparing surgery for all anal fistulas. Dis Colon Rectum 50:1535–1539PubMedCrossRef
96.
Van der Hagen SJ, Baeten CG, Soeters PB, van Gemert WG (2006) Long-term outcome following mucosal advancement flap for high perianal fistulas and fistulotomy for low perianal fistulas: recurrent perianal fistulas—failure of treatment or recurrent patient disease? Int J Colorectal Dis 21:784–790PubMedCrossRef
97.
Golub RW, Wise WE, Kerner BA, Khanduja KS, Aguilar PS (1997) Endorectal mucosal advancement flap: the preferred method for complex cryptoglandular fistula-in-ano. J Gastrointest Surg 1:487–491PubMedCrossRef
98.
Rojanasakul A, Pattanaarun J, Sahakitrungruang C, Tantiphlachiva K (2007) Total anal sphincter saving technique for fistula-in-ano; the ligation of intersphincteric fistula tract. J Med Assoc Thai 90:581–586PubMed
99.
Bleier JI, Moloo H, Goldberg SM (2010) Ligation of the intersphincteric fistula tract: an effective new technique for complex fistulas. Dis Colon Rectum 53:43–46PubMedCrossRef
100.
Shanwani A, Nor AM, Amri N (2010) Ligation of the intersphincteric fistula tract (LIFT): a sphincter-saving technique for fistula-in-ano. Dis Colon Rectum 53:39–42PubMedCrossRef
101.
Alasari S, Kim NK (2014) Overview of anal fistula and systematic review of ligation of the intersphincteric fistula tract (LIFT). Tech Coloproctol 18:13–22PubMedCrossRef
102.
Hong KD, Kang S, Kalaskar S, Wexner SD (2014) Ligation of intersphincteric fistula tract (LIFT) to treat anal fistula: systematic review and meta-analysis. Tech Coloproctol 18:685–691PubMedCrossRef
103.
Vergara-Fernandez O (2013) Ligation of intersphincteric fistula tract: what is the evidence in a review? World J Gastroenterology 19:6805–6813CrossRef
104.
Yassin NA, Hammond TM, Lunniss PJ, Phillips RK (2013) Ligation of the intersphincteric fistula tract in the management of anal fistula. A systematic review. Colorectal Dis 15:527–535PubMedCrossRef
105.
106.
Ellis CN (2010) Sphincter-preserving fistula management: what patients want. Dis Colon Rectum 53:1652–1655PubMedCrossRef
107.
Lunniss PJ, Kamm MA, Phillips RKS (1994) Factors affecting continence after surgery for anal fistula. Br J Surg 81:1382–1385PubMedCrossRef
108.
Casillas S, Hull TL, Zutshi M, Trzcinski R, Bast JF, Xu M (2005) Incontinence after a lateral internal sphincterotomy: are we underestimating it? Dis Colon Rectum 48:1193–1199PubMedCrossRef
109.
Murad-Regadas SM, Fernandes GO, Ragadas FS et al (2013) How much of the internal sphincter may be divided during lateral sphincterotomy for chronic anal fissure in women? Morphologic and functional evaluation after sphincterotomy. Dis Colon Rectum 56:645–651PubMedCrossRef
110.
Lindesy I, Smilgin-Humphreys MM, Cunningham C, Mortensen NJ, George BD (2002) A randomized, controlled trial of fibrin glue vs. conventional treatment for anal fistula. Dis Colon Rectum 45:1608–1615CrossRef
111.
Altomare DF, Greco VJ, Tricomi N et al (2011) Seton or glue for trans-sphincteric anal fistulae: a prospective randomized crossover clinical trial. Colorectal Dis 13:82–86PubMedCrossRef
112.
Singer M, Cintron J, Nelson R et al (2005) Treatment of fistulas-in-ano with fibrin sealant in combination with intra-adhesive antibiotics and/or surgical closure of the internal fistula opening. Dis Colon Rectum 48:799–808PubMedCrossRef
113.
De Parades V, Safa Far H, Etienney I, Zeitoun JD, Atienza P, Bauer P (2010) Seton drainage and fibrin glue injection for complex anal fistulas. Colorectal Dis 12:459–463PubMedCrossRef
114.
De Oca J, Millán M, Jiménez A, Golda T, Biondo S (2011) Long-term results of surgery plus fibrin sealant for anal fistula. Colorectal Dis 14:e12–e15CrossRef
115.
Haim N, Neufeld D, Ziv Y et al (2011) Long-term results of fibrin glue treatment for cryptogenic perianal fistulas: a multicenter study. Dis Colon Rectum 54:1279–1283PubMedCrossRef
116.
Buchanan GN, Bartram CI, Phillips RK et al (2003) Efficacy of fibrin sealant in the management of complex anal fistula: a prospective trial. Dis Colon Rectum 46:1167–1174PubMedCrossRef
117.
Garcia-Olmo D, Herreros D, Pascual I et al (2009) Expanded adipose-derived stem cells for the treatment of complex perianal fistula: a phase II clinical trial. Dis Colon Rectum 52:79–86PubMedCrossRef
118.
Herreros MD, Garcia Arranz M, Guadalajara H, De la Quintana P, Garcia-Olmo D, the FATT Collaborative group (2012) Autologous expanded adipose-derived stem cells for the treatment of complex cryptoglandular perianal fistulas: a phase III randomized clinical trial and long term evaluation. Dis Colon Rectum 55:762–772PubMedCrossRef
119.
A ba-bai-ke-re MM, Wen H, Huang HG et al (2011) Randomized controlled trial of minimally invasive surgery using acellular dermal matrix for complex anorectal fistula. World J Gastroenterol 16:3279–3286CrossRef
120.
Cirocchi R, Trastulli S, Morelli U et al (2013) The treatment of anal fistulas with biologically derived products: is innovation better than conventional surgical treatment? Tech Coloproctol 17:259–273PubMedCrossRef
121.
Hammond TM, Porrett TR, Scott SM, Williams NS, Lunniss PJ (2011) Management of idiopathic anal fistula using cross-linked collagen: prospective phase 1 study. Colorectal Dis 13:94–104PubMedCrossRef
122.
Sileri P, Franceschilli I, Del Vecchio Blanco G, Stolfi VM, Angelucci GP, Gaspari AL (2011) Porcine dermal collagen matrix injection may enhance flap repair surgery for complex anal fistula. Int J Colorectal Dis 26:345–349PubMedCrossRef
123.
O’Riordan JM, Datta I, Johnston M, Baxter NN (2012) A systematic review of the anal fistula plug for patients with Crohn’s or non-Crohn’s related fistula-in-ano. Dis Colon Rectum 55:351–358PubMedCrossRef
124.
Garg P, Gong J, Bhatia H, Kalia H, Menon GR (2010) The efficacy of anal fistula plug in fistula-in-ano: a systematic review. Colorectal Dis 12:965–970PubMedCrossRef
125.
Cintron JR, Abcarian H, Chaudhry V et al (2013) Treatment of fistula-in-ano using a porcine small intestinal submucosa anal fistula plug. Tech Coloproctol 17:187–191PubMedCrossRef
126.
Heydary A, Attinà GM, Merolla E, Piccoli M, Fazlalizadeh R, Melotti G (2013) Bioabsorbable synthetic plug in the treatment of anal fistulas. Dis Colon Rectum 56:774–779CrossRef
127.
De la Portilla F, Rada R, Jimenez-Rodriguez R, Diaz Pavon JM, Sanchez Gil JM (2011) Evaluation of a new synthetic plug in the treatment of anal fistulas: results of a pilot study. Dis Colon Rectum 54:1419–1422PubMedCrossRef
128.
Meinero P, Mori L (2011) Video-assisted anal fistula treatment (VAAFT): a novel sphincter-saving procedure for treating complex anal fistulas. Tech Coloproctol 15:417–422PubMedCentralPubMedCrossRef
129.
Meinero P, Mori L, Gasloli G (2014) Video-assisted anal fistula treatment: a new concept of treating anal fistulas. Dis Colon Rectum 57:354–359PubMedCrossRef
130.
Giamundo P, Geraci M, Tibaldi L, Valente M (2014) Closure of fistula-in-ano with laser–FiLaC: a novel sphincter saving technique for a complex disease. Colorectal Dis 16:110–115PubMedCrossRef
131.
Wilhelm A (2011) A new technique for sphincter-preserving anal fistula repair using a novel radial emitting laser probe. Tech Coloproctol 15:445–449PubMedCrossRef
132.
Ozturk E, Gulcu B (2014) Laser ablation of fistula tract: a sphincter-preserving method for treating fistula-in-ano. Dis Colon Rectum 57:360–364PubMedCrossRef
Metadaten
Titel
Evaluation and management of perianal abscess and anal fistula: a consensus statement developed by the Italian Society of Colorectal Surgery (SICCR)
verfasst von
A. Amato
C. Bottini
P. De Nardi
P. Giamundo
A. Lauretta
A. Realis Luc
G. Tegon
R. J. Nicholls
Publikationsdatum
01.10.2015
Verlag
Springer Milan
Erschienen in
Techniques in Coloproctology / Ausgabe 10/2015
Print ISSN: 1123-6337
Elektronische ISSN: 1128-045X
DOI
https://doi.org/10.1007/s10151-015-1365-7

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Laparoscopic ventral rectopexy is the gold standard treatment for rectal prolapse

Correspondence

Transanal endoscopic resection with peritoneal entry: a word of reason

Review

Evaluation and management of hemorrhoids: Italian society of colorectal surgery (SICCR) consensus statement

Clinical Guidelines

Practice parameters for the treatment of colonic diverticular disease: Italian Society of Colon and Rectal Surgery (SICCR) guidelines

Video Forum

Laparoscopic pelvic sidewall dissection with combined resection of internal iliac vessels for local recurrence of rectal cancer

Neu im Fachgebiet Chirurgie

Chirurginnen und Chirurgen sind stark suizidgefährdet

07.05.2024 Suizid Nachrichten

Der belastende Arbeitsalltag wirkt sich negativ auf die psychische Gesundheit der Angehörigen ärztlicher Berufsgruppen aus. Chirurginnen und Chirurgen bilden da keine Ausnahme, im Gegenteil.

Ein Drittel der jungen Ärztinnen und Ärzte erwägt abzuwandern

07.05.2024 Medizinstudium Nachrichten

Extreme Arbeitsverdichtung und kaum Supervision: Dr. Andrea Martini, Sprecherin des Bündnisses Junge Ärztinnen und Ärzte (BJÄ) über den Frust des ärztlichen Nachwuchses und die Vorteile des Rucksack-Modells.

Echinokokkose medikamentös behandeln oder operieren?

06.05.2024 DCK 2024 Kongressbericht

Die Therapie von Echinokokkosen sollte immer in spezialisierten Zentren erfolgen. Eine symptomlose Echinokokkose kann – egal ob von Hunde- oder Fuchsbandwurm ausgelöst – konservativ erfolgen. Wenn eine Op. nötig ist, kann es sinnvoll sein, vorher Zysten zu leeren und zu desinfizieren. 

Recycling im OP – möglich, aber teuer

05.05.2024 DCK 2024 Kongressbericht

Auch wenn sich Krankenhäuser nachhaltig und grün geben – sie tragen aktuell erheblich zu den CO2-Emissionen bei und produzieren jede Menge Müll. Ein Pilotprojekt aus Bonn zeigt, dass viele Op.-Abfälle wiederverwertet werden können.

Update Chirurgie

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Aktuelle BDC Leitlinien-Webinare

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare
CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare
CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare
CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.
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