Can three-dimensional anorectal ultrasonography be included as a diagnostic tool for the assessment of anal fistula before and after surgical treatment?

Detalhes bibliográficos
Autor(a) principal: Murad-Regadas, Sthela Maria
Data de Publicação: 2018
Outros Autores: Regadas Filho, Francisco Sergio P., Holanda, Erico de Carvalho, Veras, Lara Burlamaqui, Vilarinho, Adjra da Silva, Lopes, Manoel S.
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Institucional da Universidade Federal do Ceará (UFC)
Texto Completo: http://www.repositorio.ufc.br/handle/riufc/41370
Resumo: 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.
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spelling Can three-dimensional anorectal ultrasonography be included as a diagnostic tool for the assessment of anal fistula before and after surgical treatment?O ultrassom anorretal tridimensional pode ser incluído como um método diagnóstico na avaliação da fístula anal antes e após o tratamento cirúrgico?Malformações AnorretaisAnorectal MalformationsFístula RetalRectal FistulaIncontinência FecalBackground – 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.Arquivos de Gastroenterologia2019-05-03T17:43:54Z2019-05-03T17:43:54Z2018-08info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfMURAD-REGADAS, Sthela Maria et al. Can three-dimensional anorectal ultrasonography be included as a diagnostic tool for the assessment of anal fistula before and after surgical treatment?. Arq. Gastroenterol., São Paulo, v. 55, supl.1, p. 1-7, aug. 2018.Print 0004-2803On-line 1678-4219http://www.repositorio.ufc.br/handle/riufc/41370Murad-Regadas, Sthela MariaRegadas Filho, Francisco Sergio P.Holanda, Erico de CarvalhoVeras, Lara BurlamaquiVilarinho, Adjra da SilvaLopes, Manoel S.engreponame:Repositório Institucional da Universidade Federal do Ceará (UFC)instname:Universidade Federal do Ceará (UFC)instacron:UFCinfo:eu-repo/semantics/openAccess2019-05-03T17:43:54Zoai:repositorio.ufc.br:riufc/41370Repositório InstitucionalPUBhttp://www.repositorio.ufc.br/ri-oai/requestbu@ufc.br || repositorio@ufc.bropendoar:2024-09-11T19:02:49.817507Repositório Institucional da Universidade Federal do Ceará (UFC) - Universidade Federal do Ceará (UFC)false
dc.title.none.fl_str_mv Can three-dimensional anorectal ultrasonography be included as a diagnostic tool for the assessment of anal fistula before and after surgical treatment?
O ultrassom anorretal tridimensional pode ser incluído como um método diagnóstico na avaliação da fístula anal antes e após o tratamento cirúrgico?
title Can three-dimensional anorectal ultrasonography be included as a diagnostic tool for the assessment of anal fistula before and after surgical treatment?
spellingShingle Can three-dimensional anorectal ultrasonography be included as a diagnostic tool for the assessment of anal fistula before and after surgical treatment?
Murad-Regadas, Sthela Maria
Malformações Anorretais
Anorectal Malformations
Fístula Retal
Rectal Fistula
Incontinência Fecal
title_short Can three-dimensional anorectal ultrasonography be included as a diagnostic tool for the assessment of anal fistula before and after surgical treatment?
title_full Can three-dimensional anorectal ultrasonography be included as a diagnostic tool for the assessment of anal fistula before and after surgical treatment?
title_fullStr Can three-dimensional anorectal ultrasonography be included as a diagnostic tool for the assessment of anal fistula before and after surgical treatment?
title_full_unstemmed Can three-dimensional anorectal ultrasonography be included as a diagnostic tool for the assessment of anal fistula before and after surgical treatment?
title_sort Can three-dimensional anorectal ultrasonography be included as a diagnostic tool for the assessment of anal fistula before and after surgical treatment?
author Murad-Regadas, Sthela Maria
author_facet Murad-Regadas, Sthela Maria
Regadas Filho, Francisco Sergio P.
Holanda, Erico de Carvalho
Veras, Lara Burlamaqui
Vilarinho, Adjra da Silva
Lopes, Manoel S.
author_role author
author2 Regadas Filho, Francisco Sergio P.
Holanda, Erico de Carvalho
Veras, Lara Burlamaqui
Vilarinho, Adjra da Silva
Lopes, Manoel S.
author2_role author
author
author
author
author
dc.contributor.author.fl_str_mv Murad-Regadas, Sthela Maria
Regadas Filho, Francisco Sergio P.
Holanda, Erico de Carvalho
Veras, Lara Burlamaqui
Vilarinho, Adjra da Silva
Lopes, Manoel S.
dc.subject.por.fl_str_mv Malformações Anorretais
Anorectal Malformations
Fístula Retal
Rectal Fistula
Incontinência Fecal
topic Malformações Anorretais
Anorectal Malformations
Fístula Retal
Rectal Fistula
Incontinência Fecal
description 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.
publishDate 2018
dc.date.none.fl_str_mv 2018-08
2019-05-03T17:43:54Z
2019-05-03T17:43:54Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv MURAD-REGADAS, Sthela Maria et al. Can three-dimensional anorectal ultrasonography be included as a diagnostic tool for the assessment of anal fistula before and after surgical treatment?. Arq. Gastroenterol., São Paulo, v. 55, supl.1, p. 1-7, aug. 2018.
Print 0004-2803
On-line 1678-4219
http://www.repositorio.ufc.br/handle/riufc/41370
identifier_str_mv MURAD-REGADAS, Sthela Maria et al. Can three-dimensional anorectal ultrasonography be included as a diagnostic tool for the assessment of anal fistula before and after surgical treatment?. Arq. Gastroenterol., São Paulo, v. 55, supl.1, p. 1-7, aug. 2018.
Print 0004-2803
On-line 1678-4219
url http://www.repositorio.ufc.br/handle/riufc/41370
dc.language.iso.fl_str_mv eng
language eng
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Arquivos de Gastroenterologia
publisher.none.fl_str_mv Arquivos de Gastroenterologia
dc.source.none.fl_str_mv reponame:Repositório Institucional da Universidade Federal do Ceará (UFC)
instname:Universidade Federal do Ceará (UFC)
instacron:UFC
instname_str Universidade Federal do Ceará (UFC)
instacron_str UFC
institution UFC
reponame_str Repositório Institucional da Universidade Federal do Ceará (UFC)
collection Repositório Institucional da Universidade Federal do Ceará (UFC)
repository.name.fl_str_mv Repositório Institucional da Universidade Federal do Ceará (UFC) - Universidade Federal do Ceará (UFC)
repository.mail.fl_str_mv bu@ufc.br || repositorio@ufc.br
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