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dc.contributor.authorAguilar-Martínez, María del Mar-
dc.contributor.authorSánchez-Guillén, Luis-
dc.contributor.authorBarber-Valles, Xavier-
dc.contributor.authorAlcaide-Quirós, María José-
dc.contributor.authorBosch-Ramírez, Marina-
dc.contributor.authorLópez-Delgado, Alberto-
dc.contributor.authorTozer, Phil-
dc.contributor.authorArroyo, Antonio-
dc.contributor.otherDepartamentos de la UMH::Patología y Cirugíaes_ES
dc.date.accessioned2024-02-05T18:33:25Z-
dc.date.available2024-02-05T18:33:25Z-
dc.date.created2021-
dc.identifier.citationDiseases of the Colon and Rectum. 2021 Nov 1;64(11):1374-1384es_ES
dc.identifier.issn1530-0358-
dc.identifier.issn0012-3706-
dc.identifier.urihttps://hdl.handle.net/11000/31118-
dc.description.abstractBackground: Fistulotomy with immediate sphincteroplasty is a technique that can heal fistulas and decrease fecal incontinence more effectively than fistulotomy alone, in selected patients. Objective: We aimed to perform a long-term evaluation of fecal incontinence after fistulotomy and immediate sphincteroplasty in patients with complex anal fistula. Design: This prospective study included patients undergoing fistulotomy and immediate sphincteroplasty for complex anal fistula from January 2000 to December 2010. Settings: The study was conducted by 2 colorectal surgeons in the coloproctology unit of the General Hospital of Elche. Patients: We included patients aged ≥18 years with complex anal fistulas of cryptoglandular origin. Main outcome measures: Main outcomes were recurrence and continence after fistulotomy and immediate sphincteroplasty, according to fistula tract height and preoperative continence status. Results: A total of 107 patients were included; 68.2% were men, with a mean age of 48 years and mean fistula duration of 12.8 months. The range and median follow-up period were 84 to 204 and 96 months. Thirty-seven fistulas were not primary. The overall healing rate was 84.1%. Primary fistulas healed by the end of follow-up in 58 (82.9%) of 70 patients; recurrent fistulas healed in 32 (86.5%) of 37; high tracts healed in 31 (83.8%) of 37, and nonhigh fistulas healed in 59 (84.3%) of 70. Male sex (OR = 0.66 (95% CI, 0.20-2.13); p > 0.05) and recurrent fistulas (OR = 0.43 (95% CI, 0.11-1.68); p > 0.05) could have a protective effect against postoperative fecal incontinence; however, more studies with larger sample sizes are necessary to confirm this result, whereas high fistulas showed a 4-fold increased risk of incontinence (range, 1.22-13.06; p < 0.01). One in 5 high-tracts patients experienced continence deterioration. Limitations: This was a prospective study, and randomized clinical trials with more patients and longer follow-up are needed to compare fistulotomy and immediate sphincteroplasty with other sphincter-preserving techniques. Conclusions: Fistulotomy and immediate sphincteroplasty are good options for treating complex anal fistulas, especially for recurrent fistulas, men, and patients with nonhigh tracts, with acceptable recurrence and incontinence rates. See Video Abstract at http://links.lww.com/DCR/B498.es_ES
dc.formatapplication/pdfes_ES
dc.format.extent11es_ES
dc.language.isoenges_ES
dc.publisherWolters Kluweres_ES
dc.rightsinfo:eu-repo/semantics/closedAccesses_ES
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/*
dc.subjectComplex anal fistulaes_ES
dc.subjectContinencees_ES
dc.subjectFistulotomyes_ES
dc.subjectHigh fistulaes_ES
dc.subjectPrimary fistulaes_ES
dc.subjectSphinteroplastyes_ES
dc.subject.otherCDU::6 - Ciencias aplicadas::61 - Medicina::616 - Patología. Medicina clínica. Oncologíaes_ES
dc.titleLong-term Evaluation of Fistulotomy and Immediate Sphincteroplasty as a Treatment for Complex Anal Fistulaes_ES
dc.typeinfo:eu-repo/semantics/articlees_ES
dc.relation.publisherversionhttps://doi.org/10.1097/DCR.0000000000001800es_ES
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Artículos Patología y Cirugía


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