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372289

ENDOANAL ADVANCEMENT FLAP REPAIR FOR HIGH-LEVELED ANAL FISTULAE: CLINICAL AND MANOMETRIC RESULTS

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Last updated: 21 Dec 2024

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Abstract

Aim: The aim of this prospective study was to evaluate the functional outcomes after endoanal advancement flap (EAF) in treatment of high leveled anal fistulas. 
Methods: From October 2001 to December 2005, 32 patients with high anal fistulae underwent EAF. They were 26 males and 6 females, with a mean age 37.75 ± 7.2 years. Seven patients had recurrent fistulae and five had minor anal incontinence. All patients underwent coring fistulectomy followed by endoanal advancement flap that was sutured to the anoderm below the level of the internal opening. Patients were followed up for 20.16 ± 5.87 months. Continence was evaluated using a special questionnaire. 
Results: EAF was successful with a complete healing in 24 patients (75%) whereas; the overall recurrence rate was 25% after a second operation. Also, 25 patients (78.3%) experienced improved or unaffected anal continence, whereas, seven patients (21.9%) experienced minor degrees of anal incontinence. Manometrically, all patients showed significant decrease in mean resting pressure (MRP) (P: 0.000) while there was no significant changes in mean squeeze pressure (MSP) (P: 0.069) or in the functional anal canal length (P: 0.753). 
Conclusion: EAF allows the treatment of trans-sphincteric fistulae as well as supra-sphincteric fistulae without sacrificing 
anal sphincter function, which is likely to be superior to alternative procedures even in case of recurrence.

DOI

10.21608/ejsur.2007.372289

Keywords

mucosal flap repair, trans-sphincteric fistula, suprasphincteric fistula

Authors

First Name

Hesham

Last Name

Abdeldayem

MiddleName

-

Affiliation

Department of Surgery, National Liver Institute, Menoufeyia University

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Orcid

-

First Name

Ibrahim

Last Name

Abdelkader

MiddleName

-

Affiliation

Department of Surgery, National Liver Institute, Menoufeyia University

Email

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City

-

Orcid

-

First Name

Maher

Last Name

Osman

MiddleName

-

Affiliation

Department of Surgery, National Liver Institute, Menoufeyia University

Email

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City

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Orcid

-

First Name

Hesham

Last Name

Gad

MiddleName

-

Affiliation

Department of Surgery, National Liver Institute, Menoufeyia University

Email

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City

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Orcid

-

First Name

Essam

Last Name

Salah

MiddleName

-

Affiliation

Department of Surgery, National Liver Institute, Menoufeyia University

Email

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City

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Orcid

-

First Name

Amr

Last Name

Helmy

MiddleName

-

Affiliation

Department of Surgery, National Liver Institute, Menoufeyia University

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City

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Orcid

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First Name

Tarek

Last Name

Essam El-deen

MiddleName

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Affiliation

Department of Surgery, National Cancer Institute, Cairo University

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City

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Orcid

-

First Name

Ahmad

Last Name

Touny

MiddleName

-

Affiliation

Department of Surgery, National Cancer Institute, Cairo University

Email

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City

-

Orcid

-

First Name

Ossama

Last Name

Elabd

MiddleName

-

Affiliation

Radiology National Liver Institute, Menoufeyia University, Egypt

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City

-

Orcid

-

First Name

Mohamed

Last Name

El-Waraky

MiddleName

-

Affiliation

Radiology National Liver Institute, Menoufeyia University, Egypt

Email

-

City

-

Orcid

-

First Name

Hesham

Last Name

Abdel-Moneim

MiddleName

-

Affiliation

Colorectal surgery unit, Mansoura University Hospital, Faculty of Medicine, Mansoura University, Egypt

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Volume

26

Article Issue

3

Related Issue

49668

Issue Date

2007-07-01

Receive Date

2024-08-06

Publish Date

2007-07-01

Page Start

120

Page End

125

Print ISSN

1110-1121

Online ISSN

1687-7624

Article File

EJSUR_Volume 26_Issue 3_Pages 120-125.pdf

PDF . 562.0kB

Link

https://ejsur.journals.ekb.eg/article_372289.html

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https://ejsur.journals.ekb.eg/service?article_code=372289

Order

372,289

Type

Original Article

Type Code

3,086

Publication Type

Journal

Publication Title

The Egyptian Journal of Surgery

Publication Link

https://ejsur.journals.ekb.eg/

MainTitle

ENDOANAL ADVANCEMENT FLAP REPAIR FOR HIGH-LEVELED ANAL FISTULAE: CLINICAL AND MANOMETRIC RESULTS

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Article

Created At

21 Dec 2024