PMID- 30088534
OWN - NLM
STAT- MEDLINE
DCOM- 20190206
LR  - 20190215
IS  - 1678-4219 (Electronic)
IS  - 0004-2803 (Linking)
VI  - 55Suppl 1
IP  - Suppl 1
DP  - 2018 Nov
TI  - CAN THREE-DIMENSIONAL ANORECTAL ULTRASONOGRAPHY BE INCLUDED AS A DIAGNOSTIC TOOL 
      FOR THE ASSESSMENT OF ANAL FISTULA BEFORE AND AFTER SURGICAL TREATMENT?
PG  - 18-24
LID - 10.1590/S0004-2803.201800000-42 [doi]
AB  - BACKGROUND: There is no a clear knowledge concerning the division of any part of 
      the anal sphincter complex and the effect of this procedure on the function of 
      the anal canal during the treatment of perianal fistula. OBJECTIVE: To evaluate 
      the usefulness of 3D anorectal ultrasound in the assessment of anal fistula, 
      quantifying the length of the sphincter muscle to be transected, selecting 
      patients for different approaches and identifying healing, failure or recurrence 
      after the surgical treatment. METHODS: A prospective study included patients with 
      primarily cryptogenic transsphincteric anal fistula assessed by fecal 
      Incontinence score, tri-dimensional anorectal ultrasound and anal manometry 
      before and after surgery. Based on 3D-AUS, patients with >/=50% external sphincter 
      or external sphincter+puborectalis muscle involvement in males and >/=40% external 
      sphincter or external sphincter+puborectalis muscle in females were referred for 
      the ligation of the intersphincteric tract (LIFT) or seton placement and 
      subsequent fistulotomy; and with <50% involvement in males and <40% in females 
      were referred to one-stage fistulotomy. After surgery, the fibrosis (muscles 
      divided) and residual muscles were measured and compared with the pre-operative. 
      RESULTS: A total of 73 patients was included. The indication for the LIFT was 
      significantly higher in females (47%), one-stage fistulotomy was significantly 
      higher in the males (46%) and similar in seton placement. The minor postoperative 
      incontinence was identified in 31% of patients underwent sphincter divided and 
      were similar in both genders. The 3D-AUS identified seven failed cases. 
      CONCLUSION: The 3D ultrasound was shown to be an effective method in the 
      preoperative assessment of anal fistulas by quantifying the length of muscle to 
      be divided, as the results were similar at the post-operative, providing a safe 
      treatment approach according to the gender and percentage of muscle involvement. 
      Additionally, 3D ultrasound successfully identified the healing tissue and the 
      type of failure or recurrence.
FAU - Murad-Regadas, Sthela Maria
AU  - Murad-Regadas SM
AUID- ORCID: 0000-0002-9905-6981
AD  - Universidade Federal do Ceara, Faculdade de Medicina, Departamento de Cirurgia, 
      Fortaleza, CE, Brasil.
AD  - Universidade Federal do Ceara, Hospital das Clinicas, Unidade do Assoalho Pelvico 
      e Fisiologia Anorretal, Fortaleza, CE, Brasil.
AD  - Hospital Sao Carlos, Unidade do Assoalho Pelvico e Fisiologia Anorretal, 
      Departamento de Cirurgia Colorretal, Fortaleza, CE, Brasil.
FAU - Regadas Filho, Francisco Sergio P
AU  - Regadas Filho FSP
AD  - Hospital Sao Carlos, Unidade do Assoalho Pelvico e Fisiologia Anorretal, 
      Departamento de Cirurgia Colorretal, Fortaleza, CE, Brasil.
FAU - Holanda, Erico de Carvalho
AU  - Holanda EC
AD  - Universidade Federal do Ceara, Faculdade de Medicina, Departamento de Cirurgia, 
      Fortaleza, CE, Brasil.
FAU - Veras, Lara Burlamaqui
AU  - Veras LB
AD  - Hospital Sao Carlos, Unidade do Assoalho Pelvico e Fisiologia Anorretal, 
      Departamento de Cirurgia Colorretal, Fortaleza, CE, Brasil.
FAU - Vilarinho, Adjra da Silva
AU  - Vilarinho ADS
AD  - Hospital Sao Carlos, Unidade do Assoalho Pelvico e Fisiologia Anorretal, 
      Departamento de Cirurgia Colorretal, Fortaleza, CE, Brasil.
FAU - Lopes, Manoel S
AU  - Lopes MS
AD  - Universidade Federal do Ceara, Faculdade de Medicina, Departamento de Cirurgia, 
      Fortaleza, CE, Brasil.
LA  - eng
PT  - Journal Article
DEP - 20180806
PL  - Brazil
TA  - Arq Gastroenterol
JT  - Arquivos de gastroenterologia
JID - 15310600R
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Endosonography/*methods
MH  - Fecal Incontinence/*etiology
MH  - Female
MH  - Humans
MH  - Imaging, Three-Dimensional
MH  - Male
MH  - Middle Aged
MH  - Prospective Studies
MH  - Rectal Fistula/complications/*diagnostic imaging/*surgery
MH  - Recurrence
MH  - Severity of Illness Index
MH  - Treatment Outcome
MH  - Young Adult
EDAT- 2018/08/09 06:00
MHDA- 2019/02/07 06:00
CRDT- 2018/08/09 06:00
PHST- 2018/01/28 00:00 [received]
PHST- 2018/07/03 00:00 [accepted]
PHST- 2018/08/09 06:00 [pubmed]
PHST- 2019/02/07 06:00 [medline]
PHST- 2018/08/09 06:00 [entrez]
AID - S0004-28032018005002105 [pii]
AID - 10.1590/S0004-2803.201800000-42 [doi]
PST - ppublish
SO  - Arq Gastroenterol. 2018 Nov;55Suppl 1(Suppl 1):18-24. doi: 
      10.1590/S0004-2803.201800000-42. Epub 2018 Aug 6.