Background:The management of high complex anal fistulas has posed a significant challenge for surgeons.In this study,we presented a novel surgical procedure for managing high complex anal fistulas that combines core-o...Background:The management of high complex anal fistulas has posed a significant challenge for surgeons.In this study,we presented a novel surgical procedure for managing high complex anal fistulas that combines core-out fistulectomy with suture repair of the external anal sphincter defect and endorectal advancement flap.Methods:A cohort of patients with high complex anal fistulas undergoing core-out fistulectomy combined with suture repair of the external anal sphincter defect and endorectal advancement flap between December 2020 and December 2021 was reviewed retrospectively.Results:The median age of the patients was 43(range:25-53)years.All patients had high transsphincteric fistulas.Two of the five cases involved recurrent anal fistulas.During the median follow-up period of 23(range:23-34)months,no recurrence events were observed in the cohort.Furthermore,it was noted that no patients developed anal incontinence after the operation.Conclusion:Core-out fistulectomy combined with suture repair of the external anal sphincter defect and endorectal advancement flap is an effective procedure for the treatment of high complex anal fistulas.展开更多
Background:External rectal prolapse is a relatively rare disease,in which male patients account for a minority.The selection of abdominal repair or perineal repair for male patients has rarely been investigated.Method...Background:External rectal prolapse is a relatively rare disease,in which male patients account for a minority.The selection of abdominal repair or perineal repair for male patients has rarely been investigated.Methods:Fifty-one male patients receiving abdominal repair(laparoscopic ventral rectopexy)or perineal repair(Delorme or Altemeier procedures)at the Sixth Affiliated Hospital of Sun Yat-sen University(Guangzhou,China)between March 2013 and September 2019 were retrospectively analysed.We compared the recurrence,complication rate,post-operative defecation disorder,length of stay,and quality of life between the abdominal and perineal groups.Results:Of the 51 patients,45 had a complete follow-up,with a median of 48.5 months(range,22.8–101.8 months).A total of 35 patients were under age 40 years.The complication rate associated with abdominal repair was less than that associated with perineal repair(0%vs 20.7%,P=0.031)and the recurrence rate was also lower(9.5%vs 41.7%,P=0.018).Multivariate analysis showed that perineal repair(odds ratio,9.827;95%confidence interval,1.296–74.50;P=0.027)might be a risk factor for recurrence.Moreover,only perineal repair significantly improved post-operative constipation status(preoperative vs post-operative,72.4%vs 25.0%,P=0.001).There was no reported mortality in either of the groups.No patient’s sexual function was affected by the surgery.Conclusions:Both surgical approaches were safe in men.Compared with perineal repair,the complication rate and recurrence rate for abdominal repair were lower.However,perineal repair was better able to correct constipation.展开更多
Introduction Rectovaginal fistula(RVF)presents with symptoms of passage of flatus or feces through the vagina,accompanied by severe sexual and psychosocial dysfunction in patients.For high-level RVF,the transabdominal...Introduction Rectovaginal fistula(RVF)presents with symptoms of passage of flatus or feces through the vagina,accompanied by severe sexual and psychosocial dysfunction in patients.For high-level RVF,the transabdominal approach represents the standard procedure[1,2].The management of RVF poses a considerable challenge for surgeons due to the relatively high recurrence rate.展开更多
基金supported by the Guangzhou Clinical High-Tech Project,Guangdong Province[grant number 2023P-GX09]The Sixth Affiliated Hospital,Sun Yat-sen University Clinical Research 1010 Program[grant number 1010PY(2020)-18]+1 种基金The Natural Science Foundation of Guangdong Province for Distinguished Young Scholars[grant number 2022B1515020003]National Key Clinical Discipline,Guangdong Provincial Clinical Research Center for Digestive Diseases[grant number 2020B1111170004].
文摘Background:The management of high complex anal fistulas has posed a significant challenge for surgeons.In this study,we presented a novel surgical procedure for managing high complex anal fistulas that combines core-out fistulectomy with suture repair of the external anal sphincter defect and endorectal advancement flap.Methods:A cohort of patients with high complex anal fistulas undergoing core-out fistulectomy combined with suture repair of the external anal sphincter defect and endorectal advancement flap between December 2020 and December 2021 was reviewed retrospectively.Results:The median age of the patients was 43(range:25-53)years.All patients had high transsphincteric fistulas.Two of the five cases involved recurrent anal fistulas.During the median follow-up period of 23(range:23-34)months,no recurrence events were observed in the cohort.Furthermore,it was noted that no patients developed anal incontinence after the operation.Conclusion:Core-out fistulectomy combined with suture repair of the external anal sphincter defect and endorectal advancement flap is an effective procedure for the treatment of high complex anal fistulas.
基金supported by the Guangdong Medical Research Fund Project[grant number A2021171].
文摘Background:External rectal prolapse is a relatively rare disease,in which male patients account for a minority.The selection of abdominal repair or perineal repair for male patients has rarely been investigated.Methods:Fifty-one male patients receiving abdominal repair(laparoscopic ventral rectopexy)or perineal repair(Delorme or Altemeier procedures)at the Sixth Affiliated Hospital of Sun Yat-sen University(Guangzhou,China)between March 2013 and September 2019 were retrospectively analysed.We compared the recurrence,complication rate,post-operative defecation disorder,length of stay,and quality of life between the abdominal and perineal groups.Results:Of the 51 patients,45 had a complete follow-up,with a median of 48.5 months(range,22.8–101.8 months).A total of 35 patients were under age 40 years.The complication rate associated with abdominal repair was less than that associated with perineal repair(0%vs 20.7%,P=0.031)and the recurrence rate was also lower(9.5%vs 41.7%,P=0.018).Multivariate analysis showed that perineal repair(odds ratio,9.827;95%confidence interval,1.296–74.50;P=0.027)might be a risk factor for recurrence.Moreover,only perineal repair significantly improved post-operative constipation status(preoperative vs post-operative,72.4%vs 25.0%,P=0.001).There was no reported mortality in either of the groups.No patient’s sexual function was affected by the surgery.Conclusions:Both surgical approaches were safe in men.Compared with perineal repair,the complication rate and recurrence rate for abdominal repair were lower.However,perineal repair was better able to correct constipation.
基金the Ethics Committee of Sun Yat-sen Hospital,Guangzhou,P.R.China(No.2023ZSLYEC-625).
文摘Introduction Rectovaginal fistula(RVF)presents with symptoms of passage of flatus or feces through the vagina,accompanied by severe sexual and psychosocial dysfunction in patients.For high-level RVF,the transabdominal approach represents the standard procedure[1,2].The management of RVF poses a considerable challenge for surgeons due to the relatively high recurrence rate.
