Advertisement

Anorectal Abscess and Fistula

  • Carol-Ann Vasilevsky
Chapter

Abstract

Anorectal abscesses and fistula-in-ano represent different stages along the continuum of a common pathogenic spectrum. The abscess represents the acute inflammatory event while the fistula is representative of the chronic process.

Keywords

Fibrin Glue Anal Fistula External Sphincter Internal Opening Internal Sphincter 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Gordon PH. Anorectal abscess and fistula-in-ano. In: Gordon PH, Nivatvongs S, editors. Principles and practice of surgery for the colon, rectum and anus. St. Louis: Quality Medical Publishing; 1999. p. 241–86.Google Scholar
  2. 2.
    Seow-Choen F, Ho JMS. Histoanatomy of anal glands. Dis Colon Rectum. 1994;37:1215–8.PubMedGoogle Scholar
  3. 3.
    Parks AG. Pathogenesis and treatment of fistula-in-ano. Br Med J. 1961;1:463–9.PubMedGoogle Scholar
  4. 4.
    Goldberg SM, Gordon PH, Nivatvongs S. Essentials of anorectal surgery. Philadelphia: JB Lippincott; 1980. p. 100–27.Google Scholar
  5. 5.
    Abcarian H. Surgical management of recurrent anorectal abscess. Contemp Surg. 1982;21:85–91.Google Scholar
  6. 6.
    Whiteford MH, Kilkenny 3rd J, Hyman N, Buie WD, et al. Practice parameters for the treatment of perianal abscess and fistula-in-ano (revised). Dis Colon Rectum. 2005;48(7):1337–42.PubMedGoogle Scholar
  7. 7.
    Rosen SA, Coloquhoun P, Efron J, et al. Horseshoe abscesses and fistulas: how are we doing? Surg Innov. 2006;13:17–21.PubMedGoogle Scholar
  8. 8.
    Beck DE, Fazio VW, Lavery IC, et al. Catheter drainage of ischiorectal abscesses. South Med J. 1988;81:444–6.PubMedGoogle Scholar
  9. 9.
    Quah HM, Tang CL, Eu KW. Meta-analysis of randomized controlled trials comparing drainage alone vs. drainage and fistulotomy for acute perianal abscesses with proven internal opening. Int J Colorectal Dis. 2005;30:1–8.Google Scholar
  10. 10.
    Vasilevsky CA, Gordon PH. The incidence of recurrent abscesses or fistula-in-ano following anorectal suppuration. Dis Colon Rectum. 1984;27:126–30.PubMedGoogle Scholar
  11. 11.
    Scoma JA, Salvati EP, Rubin RJ. Incidence of fistulas subsequent to anal abscesses. Dis Colon Rectum. 1974;17:357–9.PubMedGoogle Scholar
  12. 12.
    Read DR, Abcarian H. A prospective survey of 474 patients with anorectal abscess. Dis Colon Rectum. 1979;22:566–9.PubMedGoogle Scholar
  13. 13.
    Hamadani A, Haigh PI, Lio IL. Who is at risk for developing chronic anal fistula or recurrent anal sepsis after initial perianal abscess? Dis Colon Rectum. 2009;52:217–21.PubMedGoogle Scholar
  14. 14.
    Tang C-L, Chew S-P, Seow-Choen F. Prospective randomized trial of drainage alone vs. drainage and fistulotomy for acute perianal abscesses with proven internal opening. Dis Colon Rectum. 1996;39:1415–7.PubMedGoogle Scholar
  15. 15.
    Schouten WR, van Vroonhoven TMJV. Treatment of anorectal abscesses with or without primary fistulectomy: results of a prospective randomized trial. Dis Colon Rectum. 1991;34:60–3.PubMedGoogle Scholar
  16. 16.
    Buchan R, Grace RH. Anorectal suppuration: the results of treatment and factors influencing the recurrence rate. Br J Surg. 1973;60:537–40.PubMedGoogle Scholar
  17. 17.
    Chrabot CM, Prasad ML, Abcarian H. Recurrent anorectal abscesses. Dis Colon Rectum. 1984;27:126–30.Google Scholar
  18. 18.
    Seow-Choen F, Nicholls RJ. Anal fistula. Br J Surg. 1992;79:197–205.PubMedGoogle Scholar
  19. 19.
    Mazier WP. The treatment and care of anal fistulas: a study of 1000 patients. Dis Colon Rectum. 1971;14:134–44.PubMedGoogle Scholar
  20. 20.
    Huber Jr P, Kissack AS, Simonton ST. Necrotizing soft tissue infection from rectal abscess. Dis Colon Rectum. 1983;26:507–11.PubMedGoogle Scholar
  21. 21.
    Bubrick MP, Hitchcock CR. Necrotizing anorectal and perineal infections. Surgery. 1979;86:655–62.PubMedGoogle Scholar
  22. 22.
    Laucks SS. Fournier’s gangrene in anorectal surgery. Surg Clin North Am. 1994;74:1339–52.PubMedGoogle Scholar
  23. 23.
    Yague-Romeo D, Angulo Hervas E, Bernai L. Fournier’s gangrene in a 44 year old woman. CT scan findings. Arch Exp Urol. 2009;62:483–5.Google Scholar
  24. 24.
    Kara E, Muezzinoglu T, Temellas G. Evaluation of risk factors and severity of a life threatening surgical emergency: Fournier’s gangrene (a report of 15 cases). Acta Chir Belg. 2009;109:191–7.PubMedGoogle Scholar
  25. 25.
    Kovalcik P, Jones J. Necrotizing perineal infections. Am Surg. 1983;49:163–6.PubMedGoogle Scholar
  26. 26.
    Abcarian H, Eftaiha M. Floating free-standing anus. A complication of massive anorectal infection. Dis Colon Rectum. 1983;26:516–21.PubMedGoogle Scholar
  27. 27.
    Cuccia G, Mucciardi G, Morgia G. Vacuum-assisted closure for treatment of Fournier’s gangrene. Urol Int. 2009;82:426–31.PubMedGoogle Scholar
  28. 28.
    Bode WE, Ramos R, Page CP. Invasive necrotizing infection secondary to anorectal abscess. Dis Colon Rectum. 1982;25:416–9.PubMedGoogle Scholar
  29. 29.
    Lucca M, Unger H, Devenny A. Treatment of Fournier’s gangrene with adjunctive hyperbaric oxygen therapy. Am J Emerg Med. 1990;8:385–7.PubMedGoogle Scholar
  30. 30.
    Kabay S, Yucel M, Yaylak F. The clinical features of Fournier’s gangrene and the predictability of the Fournier’s Gangrene Severity Index on the outcomes. Int Urol Nephrol. 2008;40:997–1004.PubMedGoogle Scholar
  31. 31.
    Barnes SG, Sattler FR, Ballard JO. Perirectal infections in acute leukemia. Improved survival after incision and debridement. Ann Intern Med. 1984;100:515–6.PubMedGoogle Scholar
  32. 32.
    Vanheuverzwyn R, Delannoy A, Michaux JL, Dive C. Anal lesions in hematologic diseases. Dis Colon Rectum. 1980;23:310–2.Google Scholar
  33. 33.
    Glenn J, Cotton D, Wesley R, Pizzo P. Anorectal infections in patients with malignant diseases. Rev Infect Dis. 1988;10:42–52.PubMedGoogle Scholar
  34. 34.
    Sehdev MK, Daviing MD, Seal SH, Stearns MW. Perianal and anorectal complications in leukemia. Cancer. 1973;31:149–52.PubMedGoogle Scholar
  35. 35.
    Levi JA, Schempff SC, Slawson RC, Wiernik PH. Evaluation of radiotherapy for localized inflammatory skin and perianal lesion in adult leukemia: a prospectively randomized double-blind study. Cancer Treat Rep. 1977;61:1301–5.PubMedGoogle Scholar
  36. 36.
    Consten CJ, Siors FJM, Noten HJ, et al. Anorectal surgery in human immunodeficiency virus-infected patients. Dis Colon Rectum. 1995;38:1169–75.PubMedGoogle Scholar
  37. 37.
    Sim A. Anorectal infection in HIV infection and AIDS: diagnosis and management. Baillières Clin Gastroenterol. 1992;6:95–103.PubMedGoogle Scholar
  38. 38.
    Miles AJG, Mellor CH, Gazzard B, et al. Surgical management of anorectal disease in HIV-positive homosexuals. Br J Surg. 1990;77:869–71.PubMedGoogle Scholar
  39. 39.
    Parks AG, Gordon PH, Hardcastle JD. A classification of ­fistula-in-ano. Br J Surg. 1976;63:1–12.PubMedGoogle Scholar
  40. 40.
    Wexner SD, Rosen L, Roberts PL, et al. Practice parameters for treatment of fistula-in-ano-supporting documentation. Dis Colon Rectum. 1996;39:1363–72.Google Scholar
  41. 41.
    Cirocco WC, Reilly JC. Challenging the predictive accuracy of Goodsall’s rule for anal fistulas. Dis Colon Rectum. 1992;35:537–42.PubMedGoogle Scholar
  42. 42.
    Sainio P, Husa A. A prospective manometric study of the effect of anal fistula surgery on anorectal function. Acta Chir Scand. 1985;151:279–88.PubMedGoogle Scholar
  43. 43.
    Weisman RI, Orsay CP, Pearl RK, Abcarian H. The role of fistulography in fistula-in-ano. Report of five cases. Dis Colon Rectum. 1991;34:181–4.PubMedGoogle Scholar
  44. 44.
    Kuijpers HC, Schulpen T. Fistulography for fistula-in-ano: is it useful? Dis Colon Rectum. 1985;28:103–4.PubMedGoogle Scholar
  45. 45.
    Cataldo P, Senagore J, Luchtefeld MA, et al. Intrarectal ultrasound in the evaluation of perirectal abscesses. Dis Colon Rectum. 1993;36:554–8.PubMedGoogle Scholar
  46. 46.
    Seow-Choen F, Burnett S, Bartram CI, Nicholls RJ. Comparison between anal endosonography and digital examination in the evaluation of anal fistulas. Br J Surg. 1991;78:445–7.Google Scholar
  47. 47.
    Lengyel AJ, Hurst NG, William JG. Preoperative assessment of anal fistulas using endoanal ultrasound. Colorectal Dis. 2002;4:436–40.PubMedGoogle Scholar
  48. 48.
    Chew SSB, Yang JL, Newstead GL, et al. Anal fistula: Levovist™ – enhanced endoanal ultrasound. A pilot study. Dis Colon Rectum. 2003;46:377–84.PubMedGoogle Scholar
  49. 49.
    Tepes B. The use of different diagnostic modalities in diagnosing fistula-in-ano. Hepatogastroenterology. 2009;54:912–5.Google Scholar
  50. 50.
    Toyonaga TI, Tajaka Y, Sing JF. Comparison of accuracy of physical examination and endoanal endosonography for preoperative assessment in patients with acute and chronic anal fistula. Tech Coloproctol. 2008;12:217–23.PubMedGoogle Scholar
  51. 51.
    Rafal RB, Nicholls JN, Cennerazzo WJ, et al. MRI for evaluation of perianal inflammation. Abdom Imaging. 1995;20:248–52.PubMedGoogle Scholar
  52. 52.
    Barker PG, Lunniss PJ, Armstrong P, et al. Magnetic resonance imaging of fistula-in-ano: technique, interpretation and accuracy. Clin Radiol. 1994;49:7–13.PubMedGoogle Scholar
  53. 53.
    Myhr GE, Myrvold HE, Nilsen G, et al. Perianal fistulas: use of MR imaging for diagnosis. Radiology. 1994;191:545–9.PubMedGoogle Scholar
  54. 54.
    Stoker J, Hussain SM, van Kempen D, et al. Endoanal coil in MR imaging of anal fistulas. AJR Am J Roentgenol. 1996;166:360–2.PubMedGoogle Scholar
  55. 55.
    West RL, Zimmerman DE, Dwarkasing S, et al. Prospective comparison of hydrogen peroxide 3-dimensional endoanal ultrasonography and endoanal magnetic resonance imaging of perianal fistulas. Dis Colon Rectum. 2003;46:1407–15.PubMedGoogle Scholar
  56. 56.
    Halligan S, Bartram CI. MR imaging of fistula-in-ano: are endoanal coils the gold standard? Am J Roentgenol. 1998;171:407–12.Google Scholar
  57. 57.
    Beets-Tan RGH, Beets GL, van de Hoop AG, et al. Preoperative MR imaging of anal fistulas: does it really help the surgeon? Radiology. 2001;218:75–84.PubMedGoogle Scholar
  58. 58.
    Buchanan GN, Halligan S, Williams AB, et al. Magnetic resonance imaging for primary fistula in ano. Br J Surg. 2003;90:877–81.PubMedGoogle Scholar
  59. 59.
    Buchanan G, Halligan A, Cohen CRG, et al. Effect of MRI on clinical outcome of recurrent fistula-in-ano. Lancet. 2002;360:1661–2.PubMedGoogle Scholar
  60. 60.
    Pearl RK, Andrews JR, Orsay CP, et al. Role of the seton in the management of anorectal fistulas. Dis Colon Rectum. 1993;36:573–9.PubMedGoogle Scholar
  61. 61.
    Ritchie RD, Sackier JM, Hode JP. Incontinence rates after cutting seton treatment for anal fistula. Colorectal Dis. 2009;11:564–71.PubMedGoogle Scholar
  62. 62.
    William JG, Farrands PA, Williams AB. The treatment of anal fistula: ACPGBI position statement. Colorectal Dis. 2007;9:18–50.Google Scholar
  63. 63.
    Nelson RL, Cintron J, Abcarian H. Dermal-island flap anoplasty for transsphincteric fistula-in-ano: assessment of treatment failures. Dis Colon Rectum. 2000;43:681–4.PubMedGoogle Scholar
  64. 64.
    Parks AG, Stitz RW. The treatment of high fistula-in-ano. Dis Colon Rectum. 1976;19:487–99.PubMedGoogle Scholar
  65. 65.
    Kennedy HL, Zegarra JP. Fistulotomy without external sphincter division for high anal fistulae. Br J Surg. 1990;77:898–901.PubMedGoogle Scholar
  66. 66.
    Fazio VW. Complex anal fistulae. Gastroenterol Clin North Am. 1987;16:93–114.PubMedGoogle Scholar
  67. 67.
    Kodner IJ, Mazor A, Shemesh GI, et al. Endorectal advancement flap repair of rectovaginal and other complicated anorectal fistulas. Surgery. 1993;114:682–90.PubMedGoogle Scholar
  68. 68.
    Sonoda T, Hull T, Piedmonte MR, Fazio VW. Outcomes of primary repair of anorectal and rectovaginal fistulas using the endorectal advancement flap. Dis Colon Rectum. 2002;45:1622–8.PubMedGoogle Scholar
  69. 69.
    Zimmerman DD, Delemarre JB, Gosselink MP, et al. Smoking affects the outcome of transanal mucosal advancement flap repair of transsphincteric fistulas. Br J Surg. 2003;90:351–4.PubMedGoogle Scholar
  70. 70.
    Kronberg O. To lay open or excise a fistula-in-ano. Br J Surg. 1985;72:970.Google Scholar
  71. 71.
    Cintron JR, Park JJ, Orsay CP, et al. Repair of fistula-in-ano using autologous fibrin tissue adhesive. Dis Colon Rectum. 1999;42:607–13.PubMedGoogle Scholar
  72. 72.
    Patrij L, Kooman B, Mortina CM, et al. Fibrin glue-antibiotic mixture in the treatment of anal fistulae: experience with 69 cases. Dig Surg. 2000;17:77–80.Google Scholar
  73. 73.
    Cintron JR, Park JJ, Orsay CP, et al. Repair of fistulas-in-ano using fibrin adhesive. Long term follow up. Dis Colon Rectum. 2000;43:944–50.PubMedGoogle Scholar
  74. 74.
    Sentovitch SM. Fibrin glue for anal fistulas: long-term results. Dis Colon Rectum. 2003;46:498–502.Google Scholar
  75. 75.
    Buchanan GN, Bartram CI, Phillips RKS, et al. Efficacy of fibrin sealant in the management of complex anal fistulas. A prospective trial. Dis Colon Rectum. 2003;46:1167–74.PubMedGoogle Scholar
  76. 76.
    You SY, Mizrahi N, Zmora O, et al. The role of endoanal ultrasound as a predictive factor in endoanal advancement flap surgery (abstract). Colorectal Dis. 2001;3 Suppl 1:76.Google Scholar
  77. 77.
    Lindsey I, Smilgen-Humphreys MM, Cunningham C, et al. Randomized controlled trial of fibrin glue vs. conventional treatment for anal fistula. Dis Colon Rectum. 2002;45:1608–15.PubMedGoogle Scholar
  78. 78.
    Zmora O, Neufeld D, Ziv Y, et al. Prospective, multienter evaluation of highly concentrated fibrin glue in the treatment of complex cryptogenic perianal fistulas. Dis Colon Rectum. 2005;48:2167–72.PubMedGoogle Scholar
  79. 79.
    Johnson EK, Gaw JU, Armstrong DN. Efficacy of anal fistula plug vs. fibrin glue in closure of anorectal fistulas. Dis Colon Rectum. 2006;49:371–6.PubMedGoogle Scholar
  80. 80.
    Adams T, Yang J, Kondylis LA, Kondylis PD. Long-term outlook after successful fibrin glue ablation of cryptoglandular transsphincteric fistula-in-ano. Dis Colon Rectum. 2008;51:1488–90.PubMedGoogle Scholar
  81. 81.
    Yeung JMC, Simpson JAD, Tang SW, et al. Fibrin glue for the treatment of fistulae-in-ano – a method worth sticking to? Colorectal Dis. 2010;12:363–6.PubMedGoogle Scholar
  82. 82.
    The Surgisis AFP anal fistula plug: report of a consensus conference. Colorectal Dis. 2007;10:17–20.Google Scholar
  83. 83.
    Champagne BJ, O’Connor LM, Ferguson M. Efficacy of anal fistula plug in closure of cryptoglandular fistulas, long term follow up. Dis Colon Rectum. 2006;49:1817–21.PubMedGoogle Scholar
  84. 84.
    Ellis CN. Bioprosthetic plug for complex anal fistulas: an early experience. J Surg Educ. 2007;64:36–40.PubMedGoogle Scholar
  85. 85.
    Schwandner O, Stadler F, Dietl O, et al. Initial experience on efficacy in closure of cryptoglandular and Crohn’s transsphincteric fistulas by the use of the anal plug. Int J Colorectal Dis. 2007;64:36–40.Google Scholar
  86. 86.
    van Koperen P, D’Hoore A, Wolthuis AM, et al. Anal fistula plug for closure of difficult anorectal fistula: a prospective study. Dis Colon Rectum. 2007;50:2168–72.PubMedGoogle Scholar
  87. 87.
    Lawes DA, Efron JE, Abbas M, et al. Early experience with bioabsorbable anal fistula plug. World J Surg. 2008;32:1157–9.PubMedGoogle Scholar
  88. 88.
    Garg P. To determine the efficacy of anal fistula plug in the treatment of high fistula-in-ano: an initial experience. Colorectal Dis. 2008;11:588–91.Google Scholar
  89. 89.
    Thekkinkattil D, Botterill I, Ambrose S, et al. Efficacy of the anal fistula plug in complex anorectal fistulae. Colorectal Dis. 2008;11:584–7.PubMedGoogle Scholar
  90. 90.
    Christoforidis D, Eltzioni DA, Goldberg SM, et al. Treatment of complex anal fistulas with the collagen fistula plug. Dis Colon Rectum. 2008;51:1482–7.PubMedGoogle Scholar
  91. 91.
    Safar B, Jobanputra S, Sands D, et al. Anal fistula plug: initial experience and outcomes. Dis Colon Rectum. 2009;52:248–52.PubMedGoogle Scholar
  92. 92.
    Ortiz H, Marzo J, Ciga F, et al. Randomized clinical trial of anal fistula plug versus endorectal advancement flap for the treatment of high crytoglandular fistula in ano. Br J Surg. 2009;96:608–12.PubMedGoogle Scholar
  93. 93.
    Rojanasakul A. LIFT procedure: a simplified technique for fistula-in-ano. Tech Coloproctol. 2009;131:237–40.Google Scholar
  94. 94.
    Moloo H, Goldberg SM. Novel correction of intersphincteric perianal fistulas preserves anal sphincter. Presented at the American College of Surgeons, October 2008, San Francisco.Google Scholar
  95. 95.
    Han JG, Xu HM, Song WL. Histologic analysis of acellular dermal matrix in the treatment of anal fistula in an animal model. J Am Coll Surg. 2009;208:1099.PubMedGoogle Scholar
  96. 96.
    Milito G, Cadeddu F. Conservative treatment for anal fistula: collagen matrix injection. J Am Coll Surg. 2009;209:542–3.PubMedGoogle Scholar
  97. 97.
    Marks CG, Ritchie JK. Anal fistulas at St. Mark’s Hospital. Br J Surg. 1977;64:84–91.PubMedGoogle Scholar
  98. 98.
    Vasilevsky CA, Gordon PH. Results of treatment of fistula-in-ano. Dis Colon Rectum. 1985;28:225–31.PubMedGoogle Scholar
  99. 99.
    Van Tets WF, Kuijpers HC. Continence disorders after anal fisulotomy. Dis Colon Rectum. 1994;37:1194–7.PubMedGoogle Scholar
  100. 100.
    Garcia-Aguilar JC, Belmonte C, Wong WD, et al. Surgical treatment of fistula-in-ano. Factors associated with recurrence and incontinence. Dis Colon Rectum. 1996;39:723–9.PubMedGoogle Scholar
  101. 101.
    Mylonakis E, Katsios C, Godevenos D, et al. Quality of life of patients after surgical treatment of anal fistula; the role of anal manometry. Colorectal Dis. 2001;3:417–21.PubMedGoogle Scholar
  102. 102.
    Malouf AJ, Buchanan GN, Carapeti A, et al. A prospective audit of fistula-in-ano at St. Mark’s hospital. Colorectal Dis. 2002;4:13–9.PubMedGoogle Scholar
  103. 103.
    Westerterp M, Volkers NA, Poolman RW, van Tets WF. Anal fistulotomy between Skylla and Charybdis. Colorectal Dis. 2003;5:549–55.PubMedGoogle Scholar
  104. 104.
    Sangwan YP, Rosen L, Riether RD, et al. Is simple fistula-in-ano simple? Dis Colon Rectum. 1994;37:885–9.PubMedGoogle Scholar
  105. 105.
    Ramanujam PS, Prasad ML, Abcarian H. The role of seton in fistulotomy of the anus. Surg Gynecol Obstet. 1983;157:419–22.PubMedGoogle Scholar
  106. 106.
    Williams JG, Macleod CAH, Goldberg SM. Seton treatment of high anal fistula. Br J Surg. 1991;78:1159–61.PubMedGoogle Scholar
  107. 107.
    Fasth SB, Nordgren S, Hulten L. Clinical course and management of suprasphincteric and extrasphincteric fistula-in-ano. Acta Chir Scand. 1990;156:397–402.PubMedGoogle Scholar
  108. 108.
    Graf W, Pahlman L, Egerbald S. Functional results after seton treatment of high transsphincteric anal fistulas. Eur J Surg. 1995;161:289–91.PubMedGoogle Scholar
  109. 109.
    Hasegawa H, Radley S, Keighley MR. Long term results of cutting seton fistulotomy. Acta Chir Iugosi. 2000;47(4 Suppl 1):19–21.Google Scholar
  110. 110.
    Schouten WR, Zimmerman DD, Briel JW, Briel JW. Transanal advancement flap repair of transsphincteric fistulas. Dis Colon Rectum. 1999;42:1419–23.PubMedGoogle Scholar
  111. 111.
    Mizrahi N, Wexner SD, Zmora O, et al. Endorectal advancement flap: are there predictors of failure? Dis Colon Rectum. 2002;45:1616–21.PubMedGoogle Scholar
  112. 112.
    Wang JY, Garcia-Aguilar J, Sternberg JA. Treatment of transsphincteric anal fistulas: are fistula plugs an acceptable alternative? Dis Colon Rectum. 2009;52:692–7.PubMedGoogle Scholar
  113. 113.
    Roig JV, Jordan J, Garcia-Armengol J. Changes in anorectal morphologic and functional parameters after fistula-in-ano surgery. Dis Colon Rectum. 2009;52:1462–9.PubMedGoogle Scholar
  114. 114.
    Seow-Choen F, Phillips RKS. Insights gained from the management of problematical anal fistulae at St. Mark’s Hospital, 1984–88. Br J Surg. 1991;78:539–41.PubMedGoogle Scholar
  115. 115.
    Lunniss PJ, Sheffield JP, Talbot IC, et al. Persistence of idiopathic anal fistula may be related to epithelialization. Br J Surg. 1995;82:32–3.PubMedGoogle Scholar
  116. 116.
    Lewis P, Bartolo DCC. Treatment of trans-sphincteric fistulae by full thickness anorectal advancement flaps. Br J Surg. 1990;77:1187–9.PubMedGoogle Scholar
  117. 117.
    Williams JG, Rothenberger DA, Nemer FD, Goldberg SM. Fistula-in-ano in Crohn’s disease. Results of aggressive surgical treatment. Dis Colon Rectum. 1991;34:378–84.PubMedGoogle Scholar
  118. 118.
    Schwartz DA, Pemberton JH, Sandborn WJ. Diagnosis and treatment of perianal fistulas in Crohn’s disease. Ann Intern Med. 2001;135:906–18.PubMedGoogle Scholar
  119. 119.
    Jenss H, Starlinger M, Skaleij M. Magnetic resonance imaging in perianal Crohn’s disease. Lancet. 1992;340:1286.PubMedGoogle Scholar
  120. 120.
    Buchmann P, Keighley MRB, Allan RN, et al. Natural history of perianal Crohn’s disease: ten-year follow-up. A plea for conservatism. Am J Surg. 1980;140:642–64.PubMedGoogle Scholar
  121. 121.
    Thia KT, Mahadavan U, Feagen BG. Ciprofloxacin or metronidazole for the treatment of perianal fistulas in patients with Crohn’s disease: a randomized double blind ­placebo-controlled pilot study. Inflamm Bowel Dis. 2009;15:17–24.PubMedGoogle Scholar
  122. 122.
    Lecomte T, Contou JF, Beaugerie L, et al. Predictive factors of response of perianal Crohn’s disease to azathioprine or 6-Mercaptopurine. Dis Colon Rectum. 2003;46:1469–75.PubMedGoogle Scholar
  123. 123.
    Present DH, Rutgeerts P, Targan S, et al. Infliximab for the treatment of fistulas in patients with Crohn’s disease. N Engl J Med. 1999;340:1398–405.PubMedGoogle Scholar
  124. 124.
    Ochsonkuhn T, Goke B, Sackman M. Combining infliximab with 6MP for fistula therapy in Crohn’s disease. Am J Gastroenterol. 2002;97:2022–5.Google Scholar
  125. 125.
    Topstad D, Panaccione R, Heine JA, et al. Combined seton placement, infliximab infusion and maintenance immunosuppressives improve healing rate in fistulizing anorectal Crohn’s disease. A single center experience. Dis Colon Rectum. 2003;46:577–83.PubMedGoogle Scholar
  126. 126.
    Sands BE, Anderson FH, Bernstein CN, et al. Infliximab maintenance therapy for fistulizing Crohn’s disease. N Engl J Med. 2004;350:876–85.PubMedGoogle Scholar
  127. 127.
    Nivatvongs S, Gordon PH. Crohn’s disease. In: Gordon PH, Nivatvongs S, editors. Principles and practice of surgery for the colon, rectum and anus. St. Louis: Quality Medical Publishing; 1999. p. 952–4.Google Scholar
  128. 128.
    Halme L, Sainio P. Factors related to frequency, type and outcome of anal fistulas in Crohn’s disease. Dis Colon Rectum. 1995;38:55–9.PubMedGoogle Scholar
  129. 129.
    Levien DH, Surrell J, Mazier WP. Surgical treatment of anorectal fistula in patients with Crohn’s disease. Surg Gynecol Obstet. 1989;169:133–6.PubMedGoogle Scholar
  130. 130.
    Van Dongen LM, Lubbers GJC. Perianal fistulas in Crohn’s disease. Arch Surg. 1986;121:1187–90.PubMedGoogle Scholar
  131. 131.
    Allan A, Keighley MRB. Management of perianal Crohn’s disease. World J Surg. 1988;12:198–202.PubMedGoogle Scholar
  132. 132.
    White RA, Eisenstat TE, Rubin RJ, Salvati EP. Seton management of complex anorectal fistulas in patients with Crohn’s disease. Dis Colon Rectum. 1990;33:587–9.PubMedGoogle Scholar
  133. 133.
    Jones OJ, Fazio VW, Jagelman DG. The use of transanal rectal advancement flaps in the management of fistulas involving the anorectum. Dis Colon Rectum. 1987;30:919–23.PubMedGoogle Scholar
  134. 134.
    Joo JS, Weiss EG, Nogueras JJ, Wexner SD. Endorectal advancement flap in perianal Crohn’s disease. Am Surg. 1998;64:147–50.PubMedGoogle Scholar
  135. 135.
    Wolff BE, Culp CE, Beart RW, et al. Anorectal Crohn’s disease: a long term prospective. Dis Colon Rectum. 1985;28:709–11.PubMedGoogle Scholar
  136. 136.
    McLeod RS. Management of fistula-in-ano: 1990 Roussel lecture. Can J Surg. 1991;34:581–5.PubMedGoogle Scholar
  137. 137.
    Beck DE. Management of anorectal Cohn’s fistulas. Clin Colon Rectal Surg. 2001;14:117–28.Google Scholar
  138. 138.
    Schwander O, Fuerst A. Preliminary results on efficacy in closure of transsphincteirc and rectovaginal fistulas associated with Crohn’s disease using new materials. Surg Innov. 2009;16:162–8.Google Scholar
  139. 139.
    Garcia-Olmo D, Garcia-Arranz M, Herreros D. Expanded adipose-derived stem cells for the treatment of complex perianal fistula including Crohn’s disease. Expert Opin Bio Ther. 2008;8:1417–23.Google Scholar
  140. 140.
    Savafi A, Gottesman L, Dailey TH. Anorectal surgery in the HIV+ patient: update. Dis Colon Rectum. 1991;34:299–304.Google Scholar
  141. 141.
    Manookian CM, Sokol TP, Hendrick C. Does HIV status influence the anatomy of anal fistulas. Dis Colon Rectum. 1998;41:1529–33.PubMedGoogle Scholar
  142. 142.
    Aleali M, Gottesman L. Anorectal disease in HIV-positive patients. Clin Colon Rectal Surg. 2001;14:265–73.Google Scholar
  143. 143.
    Schaffzin DM, Tj S, Smith LE. Perianal mucinous adenocarcinoma: unusual case presentations and review of the literature. Am Surg. 2003;69:166–9.PubMedGoogle Scholar
  144. 144.
    Sierra EM, Saenz V, Martinez PH. Mucinous adenocarcinoma associated with fistula in ano: report of a case. Tech Coloproctol. 2006;10:51–3.PubMedGoogle Scholar
  145. 145.
    Teixeira CR, Tanaka S, Haruma K. The clinical significance of the histologic subclassification of colorectal carcinoma. Oncology. 2004;50:495–9.Google Scholar
  146. 146.
    Hama Y, Makita K, Yanmana T. Mucinous adenocarcinoma arising from fistula in ano: MRI findings. AJR Am J Roentgenol. 2006;187:517–21.PubMedGoogle Scholar
  147. 147.
    Yang B-L, Shaw WJ, Sun G-D. Perianal mucinous adenocarcinoma arising from chronic anorectal fistulae: a review from single institution. Int J Colorectal Dis. 2009;24:1001–6.PubMedGoogle Scholar
  148. 148.
    Bukowski TP, Chakrabarty A, Powell IJ, et al. Acquired recto-urethral fistula: methods of repair. J Urol. 1995;153:730–3.PubMedGoogle Scholar
  149. 149.
    Blumberg JM, Lesser T, Tran VQ. Management of rectal injuries sustained during laparoscopic radical prostatectomy. Urology. 2009;73:163–6.PubMedGoogle Scholar
  150. 150.
    Thompson IM, Marx AC. Conservative therapy of rectourethral fistula: five-year follow up. Urology. 1990;6:533–6.Google Scholar
  151. 151.
    Zmora O, Potenti FM, Wexner SD, et al. Gracilis muscle transposition for iatrogenic rectourethral fistula. Ann Surg. 2003;237:483–7.PubMedGoogle Scholar
  152. 152.
    Zmora O, Tulchinsky H, Gur E, et al. Gracilis muscle transposition for fistulas between the rectum and urethra or vagina. Dis Colon Rectum. 2006;49:1316–21.PubMedGoogle Scholar
  153. 153.
    Gupta G, Kumar S, Kekre N, Gopalakrishnan G. Surgical management of rectourethral fistula. Urology. 2008;71:267–71.PubMedGoogle Scholar
  154. 154.
    Wexner SD, Ruiz DE, Genua J, et al. Gracilis muscle interposition for the treatment of rectourethral, rectovaginal and pouch-vaginal fistula. Results in 53 patients. Ann Surg. 2008;248:39–43.PubMedGoogle Scholar
  155. 155.
    Parks AG, Motson RW. Perianal repair of rectoprostatic fistula. Br J Surg. 1983;70:725–6.PubMedGoogle Scholar
  156. 156.
    Garofalo TE, Delaney CP, Jones SM, et al. Rectal advancement flap repair of rectourethral fistula. A 20-year experience. Dis Colon Rectum. 2003;46:762–9.PubMedGoogle Scholar
  157. 157.
    Prasad ML, Nelson R, Hambrick E, Abcarian H. York Mason procedure for repair of postoperative rectoprostatic urethral fistula. Dis Colon Rectum. 1983;26:716–20.PubMedGoogle Scholar
  158. 158.
    Wilbert DM, Buess G, Bichler K-H. Combined endoscopic closure of rectourethral fistula. J Urol. 1996;155:256–8.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Carol-Ann Vasilevsky
    • 1
  1. 1.Division of Colorectal Surgery, Jewish General HospitalMcGill UniversityMontrealCanada

Personalised recommendations