Your browser doesn't support javascript.
loading
Sphincter-sparing surgery for complex anal fistulas: radiofrequency thermocoagulation of the tract is of no help.
Merlini l'Héritier, A; Siproudhis, L; Bessi, G; Le Balc'h, E; Wallenhorst, T; Bouguen, G; Brochard, C.
Afiliación
  • Merlini l'Héritier A; Department of Gastroenterology, University Hospital of Rennes, Pontchaillou, France.
  • Siproudhis L; Department of Gastroenterology, University Hospital of Rennes, Pontchaillou, France.
  • Bessi G; INSERM U1241, University of Rennes 1, Rennes, France.
  • Le Balc'h E; INPHY CIC 1414, University Hospital of Rennes, Pontchaillou, France.
  • Wallenhorst T; Department of Gastroenterology, University Hospital of Rennes, Pontchaillou, France.
  • Bouguen G; Department of Gastroenterology, University Hospital of Rennes, Pontchaillou, France.
  • Brochard C; Department of Gastroenterology, University Hospital of Rennes, Pontchaillou, France.
Colorectal Dis ; 21(8): 961-966, 2019 Aug.
Article en En | MEDLINE | ID: mdl-30897291
AIM: To compare the rate of failure of radiofrequency thermocoagulation for anal fistula with that of rectal advancement flap in a case-matched study. METHOD: Patients who underwent radiofrequency treatment were compared with age- and sex-matched patients with Crohn's disease (CD) who underwent a rectal flap procedure. Fistula features, general characteristics and the main clinical events were recorded in a prospective database. Failure was defined by at least one of following: abscess, purulent discharge, visible external opening or further drainage procedure. RESULTS: A total of 62 patients [median age 45 (range 36.8-57.5) years; 22 women, 40 men; 22 with CD] were analysed. The failure rate of radiofrequency treatment was higher than that of rectal flap treatment (74.2% vs 32.2%; P = 0.004). The cumulative probabilities of failure of the radiofrequency treatment were 53.8% (38.8-68.3), 71.8% (55.3-84.0) and 87.4% (70.6-95.3) at 3, 6 and 12 months, respectively. Three patients in the radiofrequency group required drainage for an abscess and one had severe thermal ulceration. The Cox proportional hazards regression model (surgical procedure, obesity, CD) showed rectal flap treatment [3.48 (1.60-8.07); P = 0.001] and CD [2.60 (1.16-6.41); P = 0.02] to be the main independent predictors of healing. CONCLUSION: Radiofrequency thermocoagulation is a less satisfactory sphincter-sparing treatment for the management of anal fistula than a rectal flap procedure.
Asunto(s)
Palabras clave
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Colgajos Quirúrgicos / Fístula Rectal / Electrocoagulación / Tratamientos Conservadores del Órgano / Terapia por Radiofrecuencia Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies Límite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Colorectal Dis Asunto de la revista: GASTROENTEROLOGIA Año: 2019 Tipo del documento: Article País de afiliación: Francia Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Colgajos Quirúrgicos / Fístula Rectal / Electrocoagulación / Tratamientos Conservadores del Órgano / Terapia por Radiofrecuencia Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies Límite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Colorectal Dis Asunto de la revista: GASTROENTEROLOGIA Año: 2019 Tipo del documento: Article País de afiliación: Francia Pais de publicación: Reino Unido