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Additional Intraoperative Autologous-Derived Platelet-Rich Stroma to Transanal Flap Repair for the Treatment of Cryptoglandular Transsphincteric Fistulas in a Tertiary Referral Center: Long-Term Outcomes of a Prospective Pilot Study.
Bioengineering (Basel)
January 2025
Department of Gastroenterology and Hepatology, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands.
Transanal advancement flap repair (TAFR) fails in approximately 30-40% of patients with a cryptoglandular transsphincteric fistula. An additional intraoperative injection of autologous platelet-rich stroma (PRS) with TAFR proved to be safe, feasible, and effective in the short term for the treatment of cryptoglandular transsphincteric fistula in a tertiary referral center. In this study, we assessed the long-term outcomes in patients with a cryptoglandular transsphincteric fistula who were treated with an additional intraoperative autologous PRS injection with TAFR (n = 43).
View Article and Find Full Text PDFTransanal Opening of the Intersphincteric Space (TROPIS) for Managing High Complex Perianal Fistula in a Crohn's Disease Case with Anorectal Stenosis.
Dig Dis Sci
February 2025
Coloproctology Department, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 200030, China.
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, Virgen del Rocío University Hospital, Seville, 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.
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