PMID- 22231563
OWN - NLM
STAT- MEDLINE
DCOM- 20120807
LR  - 20211021
IS  - 1128-045X (Electronic)
IS  - 1123-6337 (Print)
IS  - 1123-6337 (Linking)
VI  - 16
IP  - 2
DP  - 2012 Apr
TI  - Identification of epithelialization in high transsphincteric fistulas.
PG  - 113-7
LID - 10.1007/s10151-011-0803-4 [doi]
AB  - BACKGROUND: At present, transanal advancement flap repair (TAFR) is the treatment 
      of choice for transsphincteric fistulas passing through the upper and middle 
      third of the external anal sphincter. It has been suggested that 
      epithelialization of the fistula tract contributes to the failure of the 
      treatment. The aim of this study was to assess the prevalence of 
      epithelialization of the fistula tract and to study its effect on the outcome of 
      TAFR and TAFR combined with ligation of the intersphincteric fistula tract 
      (LIFT). METHODS: Forty-four patients with a high transsphincteric fistula of 
      cryptoglandular origin underwent TAFR. Nine of these patients underwent a 
      combined procedure of TAFR with LIFT. In all patients the fistula tract was 
      excised from the external opening up to the outer border of the external anal 
      sphincter. In patients undergoing TAFR combined with LIFT an additional central 
      part of the intersphincteric fistula tract was excised. A total of 53 specimens 
      were submitted. Histopathological examination of the specimens was carried out by 
      a pathologist, blinded for clinical data. RESULTS: Epithelialization of the 
      distal and intersphincteric fistula tract was observed in only 25 and 22% of 
      fistulas, respectively. There was no difference in outcome between fistulas with 
      or without epithelialization. CONCLUSIONS: Epithelialization of high 
      transsphincteric fistulas is rare and does not affect the outcome of TAFR and 
      TAFR combined with LIFT.
CI  - (c) The Author(s) 2012. This article is published with open access at 
      Springerlink.com
FAU - Mitalas, L E
AU  - Mitalas LE
AD  - Division of Colon and Rectal Surgery, Department of Surgery, Erasmus MC, 
      University Medical Center, H 181,'s Gravendijkwal 230, 3015 CE Rotterdam, The 
      Netherlands.
FAU - van Onkelen, R S
AU  - van Onkelen RS
FAU - Monkhorst, K
AU  - Monkhorst K
FAU - Zimmerman, D D
AU  - Zimmerman DD
FAU - Gosselink, M P
AU  - Gosselink MP
FAU - Schouten, W R
AU  - Schouten WR
LA  - eng
PT  - Journal Article
DEP - 20120110
PL  - Italy
TA  - Tech Coloproctol
JT  - Techniques in coloproctology
JID - 9613614
SB  - IM
MH  - Adult
MH  - Aged
MH  - Cutaneous Fistula/*pathology/surgery
MH  - Epithelium/growth & development
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Rectal Fistula/*pathology/surgery
MH  - Surgical Flaps
MH  - Treatment Outcome
MH  - *Wound Healing
MH  - Young Adult
PMC - PMC3310980
EDAT- 2012/01/11 06:00
MHDA- 2012/08/08 06:00
PMCR- 2012/01/10
CRDT- 2012/01/11 06:00
PHST- 2011/09/12 00:00 [received]
PHST- 2011/12/10 00:00 [accepted]
PHST- 2012/01/11 06:00 [entrez]
PHST- 2012/01/11 06:00 [pubmed]
PHST- 2012/08/08 06:00 [medline]
PHST- 2012/01/10 00:00 [pmc-release]
AID - 803 [pii]
AID - 10.1007/s10151-011-0803-4 [doi]
PST - ppublish
SO  - Tech Coloproctol. 2012 Apr;16(2):113-7. doi: 10.1007/s10151-011-0803-4. Epub 2012 
      Jan 10.