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15.06.2017 | Review

Pathogenesis and persistence of cryptoglandular anal fistula: a systematic review

verfasst von: Jeremy Sugrue, Johan Nordenstam, Herand Abcarian, Amelia Bartholomew, Joel L. Schwartz, Anders Mellgren, Philip J. Tozer

Erschienen in: Techniques in Coloproctology | Ausgabe 6/2017

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Abstract

Anal fistulas continue to be a problem for patients and surgeons alike despite scientific advances. While patient and anatomical characteristics are important to surgeons who are evaluating patients with anal fistulas, their development and persistence likely involves a multifaceted interaction of histological, microbiological, and molecular factors. Histological studies have shown that anal fistulas are variably epithelialized and are surrounded by dense collagen tissue with pockets of inflammatory cells. Yet, it remains unknown if or how histological differences impact fistula healing. The presence of a perianal abscess that contains gut flora commonly leads to the development of anal fistula. This implies a microbiological component, but bacteria are infrequently found in chronic fistulas. Recent work has shown an increased expression of proinflammatory cytokines and epithelial to mesenchymal cell transition in both cryptoglandular and Crohn’s perianal fistulas. This suggests that molecular mechanisms may also play a role in both fistula development and persistence. The aim of this study was to examine the histological, microbiological, molecular, and host factors that contribute to the development and persistence of anal fistulas.

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Titel: Pathogenesis and persistence of cryptoglandular anal fistula: a systematic review
verfasst von: Jeremy Sugrue
Johan Nordenstam
Herand Abcarian
Amelia Bartholomew
Joel L. Schwartz
Anders Mellgren
Philip J. Tozer
Publikationsdatum: 15.06.2017
Verlag: Springer International Publishing
Erschienen in: Techniques in Coloproctology / Ausgabe 6/2017
Print ISSN: 1123-6337
Elektronische ISSN: 1128-045X
DOI: https://doi.org/10.1007/s10151-017-1645-5

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Pathogenesis and persistence of cryptoglandular anal fistula: a systematic review

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