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Anoplasty

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Richard L Nelson – 1st expert on this subject based on the ideXlab platform

  • dermal island flap Anoplasty for transsphincteric fistula in ano assessment of treatment failures
    Diseases of The Colon & Rectum, 2000
    Co-Authors: Richard L Nelson, Jose R Cintron, Herand Abcarian

    Abstract:

    PURPOSE: The aim of this study was to assess the treatment failures of island-flap Anoplasty for fistula-in-ano, a procedure designed to treat fistula without sphincter division. METHODS: Data concerning all patients having dermal island-flap Anoplasty for the treatment of transsphincteric fistula were reviewed. Variables assessed were age, gender, radial fistula location, cause, Crohn’s disease, previous fistula operations, other complicating illnesses, internal sphincter closure, simultaneous use of fibrin adhesive injection, and use of combined dermal and rectal flap for large fistulas. Postoperative data collected included persistence of the distal tract, recurrence of the fistula, and treatment of the recurrence. Recurrence (or persistence) of the fistula was the dependant variable and each risk factor for recurrence was assessed using chi-squared analyses. RESULTS: Seventy-three flaps were performed in 65 individuals. Recurrence developed 17 times in 13 individuals. Recurrence was more likely to occur in males, patients who have had previous treatment of fistulas, patients with large fistulas requiring combined flaps, and patients who had simultaneous fibrin glue injection. Patients with Crohn’s disease and individuals having internal sphincter closure had fewer recurrences. Factors reaching statistical significance included closure of the internal sphincter, the use of fibrin glue, and cause of the fistula. CONCLUSION: No specific anatomic or demographic characteristic is sufficiently associated with failure to exclude any patient from the operation. Closure of the internal sphincter should be done as part of the procedure and fibrin glue injection should not be done simultaneously.

  • island flap Anoplasty for treatment of transsphincteric fistula in ano
    Diseases of The Colon & Rectum, 1996
    Co-Authors: Alberto Del Pino, Russell K Pearl, Richard L Nelson, Herand Abcarian

    Abstract:

    BACKGROUND: Treatment of fistula-in-ano often replaces one problem, risk of persistent anal sepsis, with another, either incontinence after fistulotomy or mucosal ectropion after rectal flap advancement. A new technique for treatment of transsphincteric fistulas is described that could eliminate risk of both complications. TECHNIQUE: Island flap Anoplasty, previously used in management of anal strictures or ectropion, is modified to treat transsphincteric fistulas. RESULTS: The operation has been performed in 11 patients, 3 of whom had Crohn’s disease. Follow-up varied from one to ten months. Early recurrences have occurred in three patients, two with Crohn’s disease and one without. Remaining patients have done well. CONCLUSION: This procedure is technically easy to perform and appears to cure transsphincteric fistulas while preserving anal sphincter. In the event of persistence of fistula, other operative options are not eliminated by this procedure. We feel that further experience and longer follow-up is needed to define precise indications for this procedure and to determine if continence is improved more so than with standard fistulotomy.

  • island flap Anoplasty for the treatment of anal stricture and mucosal ectropion
    Diseases of The Colon & Rectum, 1990
    Co-Authors: Russell K Pearl, Richard L Nelson, Vendie H Hooks, Herand Abcarian, Charles P Orsay

    Abstract:

    Twenty patients with benign anal strictures and five patients with mucosal ectropion were treated with island flap Anoplasty. U-shaped or diamond-shaped islands of perianal skin were created, without undermining, and advanced into the anal canal to remedy the stricture or site of ectropion. Over a postoperative follow-up period that averaged 19 months, 16 patients judged their clinical results as excellent and 7 as good. There were two failures. In all patients the skin flaps survived, even in the elderly patients. Island flap Anoplasty is a simple, effective alternative to other forms of Anoplasty such as Y-V advancement or S-plasty.

Herand Abcarian – 2nd expert on this subject based on the ideXlab platform

  • dermal island flap Anoplasty for transsphincteric fistula in ano assessment of treatment failures
    Diseases of The Colon & Rectum, 2000
    Co-Authors: Richard L Nelson, Jose R Cintron, Herand Abcarian

    Abstract:

    PURPOSE: The aim of this study was to assess the treatment failures of island-flap Anoplasty for fistula-in-ano, a procedure designed to treat fistula without sphincter division. METHODS: Data concerning all patients having dermal island-flap Anoplasty for the treatment of transsphincteric fistula were reviewed. Variables assessed were age, gender, radial fistula location, cause, Crohn’s disease, previous fistula operations, other complicating illnesses, internal sphincter closure, simultaneous use of fibrin adhesive injection, and use of combined dermal and rectal flap for large fistulas. Postoperative data collected included persistence of the distal tract, recurrence of the fistula, and treatment of the recurrence. Recurrence (or persistence) of the fistula was the dependant variable and each risk factor for recurrence was assessed using chi-squared analyses. RESULTS: Seventy-three flaps were performed in 65 individuals. Recurrence developed 17 times in 13 individuals. Recurrence was more likely to occur in males, patients who have had previous treatment of fistulas, patients with large fistulas requiring combined flaps, and patients who had simultaneous fibrin glue injection. Patients with Crohn’s disease and individuals having internal sphincter closure had fewer recurrences. Factors reaching statistical significance included closure of the internal sphincter, the use of fibrin glue, and cause of the fistula. CONCLUSION: No specific anatomic or demographic characteristic is sufficiently associated with failure to exclude any patient from the operation. Closure of the internal sphincter should be done as part of the procedure and fibrin glue injection should not be done simultaneously.

  • island flap Anoplasty for treatment of transsphincteric fistula in ano
    Diseases of The Colon & Rectum, 1996
    Co-Authors: Alberto Del Pino, Russell K Pearl, Richard L Nelson, Herand Abcarian

    Abstract:

    BACKGROUND: Treatment of fistula-in-ano often replaces one problem, risk of persistent anal sepsis, with another, either incontinence after fistulotomy or mucosal ectropion after rectal flap advancement. A new technique for treatment of transsphincteric fistulas is described that could eliminate risk of both complications. TECHNIQUE: Island flap Anoplasty, previously used in management of anal strictures or ectropion, is modified to treat transsphincteric fistulas. RESULTS: The operation has been performed in 11 patients, 3 of whom had Crohn’s disease. Follow-up varied from one to ten months. Early recurrences have occurred in three patients, two with Crohn’s disease and one without. Remaining patients have done well. CONCLUSION: This procedure is technically easy to perform and appears to cure transsphincteric fistulas while preserving anal sphincter. In the event of persistence of fistula, other operative options are not eliminated by this procedure. We feel that further experience and longer follow-up is needed to define precise indications for this procedure and to determine if continence is improved more so than with standard fistulotomy.

  • island flap Anoplasty for the treatment of anal stricture and mucosal ectropion
    Diseases of The Colon & Rectum, 1990
    Co-Authors: Russell K Pearl, Richard L Nelson, Vendie H Hooks, Herand Abcarian, Charles P Orsay

    Abstract:

    Twenty patients with benign anal strictures and five patients with mucosal ectropion were treated with island flap Anoplasty. U-shaped or diamond-shaped islands of perianal skin were created, without undermining, and advanced into the anal canal to remedy the stricture or site of ectropion. Over a postoperative follow-up period that averaged 19 months, 16 patients judged their clinical results as excellent and 7 as good. There were two failures. In all patients the skin flaps survived, even in the elderly patients. Island flap Anoplasty is a simple, effective alternative to other forms of Anoplasty such as Y-V advancement or S-plasty.

Russell K Pearl – 3rd expert on this subject based on the ideXlab platform

  • island flap Anoplasty for treatment of transsphincteric fistula in ano
    Diseases of The Colon & Rectum, 1996
    Co-Authors: Alberto Del Pino, Russell K Pearl, Richard L Nelson, Herand Abcarian

    Abstract:

    BACKGROUND: Treatment of fistula-in-ano often replaces one problem, risk of persistent anal sepsis, with another, either incontinence after fistulotomy or mucosal ectropion after rectal flap advancement. A new technique for treatment of transsphincteric fistulas is described that could eliminate risk of both complications. TECHNIQUE: Island flap Anoplasty, previously used in management of anal strictures or ectropion, is modified to treat transsphincteric fistulas. RESULTS: The operation has been performed in 11 patients, 3 of whom had Crohn’s disease. Follow-up varied from one to ten months. Early recurrences have occurred in three patients, two with Crohn’s disease and one without. Remaining patients have done well. CONCLUSION: This procedure is technically easy to perform and appears to cure transsphincteric fistulas while preserving anal sphincter. In the event of persistence of fistula, other operative options are not eliminated by this procedure. We feel that further experience and longer follow-up is needed to define precise indications for this procedure and to determine if continence is improved more so than with standard fistulotomy.

  • island flap Anoplasty for the treatment of anal stricture and mucosal ectropion
    Diseases of The Colon & Rectum, 1990
    Co-Authors: Russell K Pearl, Richard L Nelson, Vendie H Hooks, Herand Abcarian, Charles P Orsay

    Abstract:

    Twenty patients with benign anal strictures and five patients with mucosal ectropion were treated with island flap Anoplasty. U-shaped or diamond-shaped islands of perianal skin were created, without undermining, and advanced into the anal canal to remedy the stricture or site of ectropion. Over a postoperative follow-up period that averaged 19 months, 16 patients judged their clinical results as excellent and 7 as good. There were two failures. In all patients the skin flaps survived, even in the elderly patients. Island flap Anoplasty is a simple, effective alternative to other forms of Anoplasty such as Y-V advancement or S-plasty.