AI Article Synopsis
- The study aimed to analyze the formation of horseshoe tracts in anal fistulas by reviewing data from patients who underwent surgery between 2004 and 2011.
- A total of 1,876 patients were analyzed, with 82 (4.4%) having horseshoe extensions, primarily affecting males with a median age of 46; most cases had a high transsphincteric primary tract.
- The findings indicated that horseshoe extensions are rare and commonly occur in patients with previous treatments, particularly in non-Crohn's disease cases.
Article Abstract
Aim: The aim of this study was to analyse the characteristics of horseshoe tract formation in anal fistula.
Method: We retrospectively analysed the data from all consecutive patients who underwent surgery for an anal fistula from November 2004 to March 2011. A horseshoe tract was defined as a circumferential extension connecting both sides of the anorectum.
Results: During the period of analysis, 1876 patients were operated on for a fistula. Of these, 82 (4.4%) had a horseshoe extension. The majority (72%) were male and the median age was 46 (17-84) years. The primary tract was high transsphincteric in 90% of cases and the primary opening was posterior in 65% of cases. The location of the horseshoe extension was posterior in 66% of cases with spread in the deep perianal space in 62%. In all, 71% were cryptoglandular and 24% were seen in Crohn's disease (20). Of the 62 non-Crohn's patients previous treatment was common and included surgery (42), antibiotics alone (41) and non-steroidal anti-inflammatory drugs (21).
Conclusion: Horseshoe extension in anal fistula is uncommon. With Crohn's disease excepted, the majority had had previous treatment.
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| http://dx.doi.org/10.1111/j.1463-1318.2012.03034.x | DOI Listing |
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