External sphincter-sparing anal fistulotomy plus seton drainage for complex fistula-in-ano
Several sphincter-saving surgical techniques have been developed, but overall healing rates have been mediocre. An external sphincter-sparing anal fistulotomy plus seton drainage (ESSAF-S) prioritizes the management of the intersphincteric space and involves dividing the internal sphincter and debri...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Galenos Publishing House
2024
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| Online Access: | http://psasir.upm.edu.my/id/eprint/117057/ http://psasir.upm.edu.my/id/eprint/117057/1/117057.pdf |
| _version_ | 1848867154952192000 |
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| author | Amin-Tai, Hizami Adznan, Muhammad Ash-Shafhawi Demirli Atıcı, Semra Canda, Aras Emre Terzi, Mustafa Cem Füzün, Mehmet |
| author_facet | Amin-Tai, Hizami Adznan, Muhammad Ash-Shafhawi Demirli Atıcı, Semra Canda, Aras Emre Terzi, Mustafa Cem Füzün, Mehmet |
| author_sort | Amin-Tai, Hizami |
| building | UPM Institutional Repository |
| collection | Online Access |
| description | Several sphincter-saving surgical techniques have been developed, but overall healing rates have been mediocre. An external sphincter-sparing anal fistulotomy plus seton drainage (ESSAF-S) prioritizes the management of the intersphincteric space and involves dividing the internal sphincter and debriding the intersphincteric space to remove the focus of fistula formation. Method: This was a retrospective review of all patients who underwent ESSAF-S between January 2020 and December 2021 in a single institution. The primary outcome was the primary healing rate. Secondary outcomes included overall healing rate, postoperative complications, and incontinence rate based on the postoperative Wexner incontinence score (WIS). Results: A total of 21 patients (11 men, 10 women, mean age 43.1±12.3 years) underwent ESSAF-S during the study period. The mean follow-up time was 11.9±4.4 months. The primary healing rate was 76.2%. Five patients required a second procedure (3 fistulotomy, 2 fistula-tract laser closure), and 1 patient had a persistent fistula afterward. The overall healing rate was 95.2%. Two (9.5%) patients developed gas incontinence after the procedure. The median WIS was 0 (range: 0-13). There was no significant difference between the preoperative and postoperative WIS (p>0.05). Conclusion: An external sphincter-sparing anal fistulotomy plus seton drainage is an effective procedure for complex anal fistula with a high overall healing rate and low complication rate. |
| first_indexed | 2025-11-15T14:32:00Z |
| format | Article |
| id | upm-117057 |
| institution | Universiti Putra Malaysia |
| institution_category | Local University |
| language | English |
| last_indexed | 2025-11-15T14:32:00Z |
| publishDate | 2024 |
| publisher | Galenos Publishing House |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | upm-1170572025-04-23T07:46:41Z http://psasir.upm.edu.my/id/eprint/117057/ External sphincter-sparing anal fistulotomy plus seton drainage for complex fistula-in-ano Amin-Tai, Hizami Adznan, Muhammad Ash-Shafhawi Demirli Atıcı, Semra Canda, Aras Emre Terzi, Mustafa Cem Füzün, Mehmet Several sphincter-saving surgical techniques have been developed, but overall healing rates have been mediocre. An external sphincter-sparing anal fistulotomy plus seton drainage (ESSAF-S) prioritizes the management of the intersphincteric space and involves dividing the internal sphincter and debriding the intersphincteric space to remove the focus of fistula formation. Method: This was a retrospective review of all patients who underwent ESSAF-S between January 2020 and December 2021 in a single institution. The primary outcome was the primary healing rate. Secondary outcomes included overall healing rate, postoperative complications, and incontinence rate based on the postoperative Wexner incontinence score (WIS). Results: A total of 21 patients (11 men, 10 women, mean age 43.1±12.3 years) underwent ESSAF-S during the study period. The mean follow-up time was 11.9±4.4 months. The primary healing rate was 76.2%. Five patients required a second procedure (3 fistulotomy, 2 fistula-tract laser closure), and 1 patient had a persistent fistula afterward. The overall healing rate was 95.2%. Two (9.5%) patients developed gas incontinence after the procedure. The median WIS was 0 (range: 0-13). There was no significant difference between the preoperative and postoperative WIS (p>0.05). Conclusion: An external sphincter-sparing anal fistulotomy plus seton drainage is an effective procedure for complex anal fistula with a high overall healing rate and low complication rate. Galenos Publishing House 2024-03-11 Article PeerReviewed text en cc_by_nc_4 http://psasir.upm.edu.my/id/eprint/117057/1/117057.pdf Amin-Tai, Hizami and Adznan, Muhammad Ash-Shafhawi and Demirli Atıcı, Semra and Canda, Aras Emre and Terzi, Mustafa Cem and Füzün, Mehmet (2024) External sphincter-sparing anal fistulotomy plus seton drainage for complex fistula-in-ano. Turkish Journal of Colorectal Disease. pp. 19-35. https://turkishjcrd.com/articles/doi/tjcd.galenos.2024.2022-9-6 10.4274/tjcd.galenos.2024.2022-9-6 |
| spellingShingle | Amin-Tai, Hizami Adznan, Muhammad Ash-Shafhawi Demirli Atıcı, Semra Canda, Aras Emre Terzi, Mustafa Cem Füzün, Mehmet External sphincter-sparing anal fistulotomy plus seton drainage for complex fistula-in-ano |
| title | External sphincter-sparing anal fistulotomy plus seton drainage for complex fistula-in-ano |
| title_full | External sphincter-sparing anal fistulotomy plus seton drainage for complex fistula-in-ano |
| title_fullStr | External sphincter-sparing anal fistulotomy plus seton drainage for complex fistula-in-ano |
| title_full_unstemmed | External sphincter-sparing anal fistulotomy plus seton drainage for complex fistula-in-ano |
| title_short | External sphincter-sparing anal fistulotomy plus seton drainage for complex fistula-in-ano |
| title_sort | external sphincter-sparing anal fistulotomy plus seton drainage for complex fistula-in-ano |
| url | http://psasir.upm.edu.my/id/eprint/117057/ http://psasir.upm.edu.my/id/eprint/117057/ http://psasir.upm.edu.my/id/eprint/117057/ http://psasir.upm.edu.my/id/eprint/117057/1/117057.pdf |