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Video demonstration of the modified Parks’ technique for treatment of trans-sphincteric anal fistula

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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Background

Trans-sphincteric anal fistula (TAF) is a common type of anal fistula that can be divided into low and high subtypes. Sphincter-sparing surgery is usually used for treatment of high TAF to avoid any compromise of the anal continence.

Methods

A 38-year-old male patient with recurrent Grade III TAF was treated with the modified Parks’ technique. This technique can be summarized as three main steps; each addresses a component of the anal fistula. (1) The extra-sphincteric component, which lies outside the external anal sphincter (EAS), is laid open with electrocautery. (2) The intersphincteric component is laid open, starting from the internal opening, dividing the internal anal sphincter, until the EAS fibers were reached. (3) The trans-sphincteric component that traverses the EAS was carefully curetted from the anal and the outer sides with a surgical curette. An important step of the procedure is to close the defect through which the fistula tract passed through the EAS with interrupted sutures.

Results

The operation time was 35 min. Complete healing was achieved in 5 weeks with no persistence or recurrence of the anal fistula after a follow-up of 6 months. No affection of the continence state was recorded.

Conclusion

The modified Parks’ technique is a simple and convenient operation for TAF. Further prospective studies are needed to substantiate the efficacy and safety of the procedure.

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Authors and Affiliations

  1. Colorectal Surgery Unit, General Surgery Department, Mansoura University Hospitals, Mansoura University, Mansoura City, Egypt

    Sameh Hany Emile, Hisham Elnaghi & Mohamed El-Said

Authors
  1. Sameh Hany Emile
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  2. Hisham Elnaghi
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  3. Mohamed El-Said
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Contributions

Sameh Emile performed the procedure, edited the video, and wrote the manuscript. Hisham Elnaghi took the video, collected the data, and revised the manuscript. Mohamed El-Said edited the video and revised the manuscript.

Corresponding author

Correspondence to Sameh Hany Emile.

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The authors declare that they have no conflicts of interest.

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Emile, S.H., Elnaghi, H. & El-Said, M. Video demonstration of the modified Parks’ technique for treatment of trans-sphincteric anal fistula. J Gastrointest Surg 25, 1089–1090 (2021). https://doi.org/10.1007/s11605-020-04902-1

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  • DOI: https://doi.org/10.1007/s11605-020-04902-1

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