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Closed trans-intersphincteric fistulotomy: a new modified sphincter-sparing technique for high transsphincteric anal fistula.
Front Surg
December 2024
Department of Anorectal Diseases, Shanghai Baoshan District Integrated Traditional Chinese and Western Medicine Hospital, Shanghai, China.
Background: The main goals of surgery for fistula-in-ano are to completely resolve the condition and maintain optimal anal function. Effective management of the internal opening during and proper postoperative drainage of the intersphincter plane are crucial for achieving successful outcomes. This study evaluated the clinical efficacy of a novel sphincter-sparing technique for treating high transsphincteric anal fistula (HTAF).
View Article and Find Full Text PDFResults at one year of the TROPIS technique in the treatment of complex anal fistula.
Cir Esp (Engl Ed)
December 2024
Full professor at the University of Seville, Department of General and Digestive Surgery, Head of the Coloproctology Unit, Hospital Universitario Virgen del Rocío, Sevilla, Spain.
Introduction: It is a priority to find surgical techniques that guarantee acceptable healing rates without sequelae in the treatment of complex anal fistula. The concept of the deep intersphincteric space as the origin of perianal sepsis has provided a new perspective, allowing the emergence of techniques such as TROPIS (Transanal Opening of Intersphincteric Space), with few published series to date. The aim of this study is to evaluate the healing rate and complications one year after the TROPIS technique as a treatment for complex anal fistula without hospitalization.
View Article and Find Full Text PDFTransanal Opening of the Sphincter Space Is a Concept Based on Garg Cardinal Principles.
J Am Coll Surg
December 2024
Garg Fistula Research Institute, Panchkula, Haryana, India.
High complex anal fistula managed by the modified transanal opening of the intersphincteric space the inter-sphincteric approach: A case report.
World J Radiol
October 2024
Anorectal Disease Center, Jiangsu Province traditional Chinese Medicine Innovation Center for Anorectal Disease, Nanjing 211000, Jiangsu Province, China.
Article Synopsis
- High complex anal fistulas are challenging to treat due to their location above the deep external sphincter, and traditional surgeries often lead to loss of anal function.
- The modified Transanal opening of the intersphincteric space (TROPIS) procedure effectively treats these fistulas while preserving anal sphincter function, minimizing the risks associated with conventional methods.
- A recent case showed successful results with the modified TROPIS, as the patient experienced a full recovery and normal anal function after 17 months, demonstrating its potential as a preferred treatment option.
Transanal circumferential pouch advancement for treatment of pouch vaginal fistulae.
Tech Coloproctol
August 2024
Department of Colon and Rectal Surgery, Digestive Disease and Surgery Institute, Cleveland Clinic Main Campus, 9500, Cleveland, OH, 44122, USA.
Background: Ileal pouch anal anastomosis (IPAA) circumferential pouch advancement (CPA) involves full-thickness transanal 180-360° dissection of the distal pouch, allowing the advancement of healthy bowel to cover the internal opening of a vaginal fistula. We aimed to describe the long-term outcomes of this rare procedure.
Methods: Patients with IPAA who underwent transanal pouch advancement for any indication between 2009 and 2021 were included.
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