Advancement Flap Repair (advancement + flap_repair)

Distribution by Scientific Domains


Selected Abstracts


Treatment of rectovaginal fistula: A 5-year review

AUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 1 2006
Damian CASADESUS
This paper presents a chart review of 17 patients who had been treated for rectovaginal fistula (RVF) from 1996 to 2000. In most cases (13; 76.5%), the fistula was the result of post-surgical complications. Following vaginal mucosa advancement flap repair or repair after conversion to a fourth-degree perineal laceration, 16 (94%) of the rectovaginal fistulae (during the first attempted repair or after failed treatment) were successfully treated. In all patients but one, faecal diversion was avoided. In two patients, fistulography was both a diagnostic procedure and the method of treatment. [source]


Endorectal flap advancement repair and fistulectomy for high trans-sphincteric and suprasphincteric fistulas

BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 12 2000
Dr H. Ortíz
Background Low-lying trans-sphincteric anal fistulas respond well to simple fistulectomy or fistulotomy. However, management of high fistulas has long been a serious problem because of the necessity of preserving at least some of the sphincter mechanism. The clinical results of endorectal flap advancement and fistulectomy for complex anal fistulas were assessed. Methods A total of 103 consecutive patients with high trans-sphincteric (n = 91) and suprasphincteric (n = 12) fistulas undergoing endorectal advancement flap repair together with core fistulectomy were included in a prospective study. Clinical outcome was assessed in terms of continence and recurrence by an independent observer for a period of 1 year after operation. Results Successful healing was achieved in 96 patients (93 per cent). Recurrent fistula occurred in six (7 per cent) of the 91 patients in the trans-sphincteric group and in one of the 12 patients in the suprasphincteric group. Continence disturbance was noted in eight patients (8 per cent). Previous repair and the level of the fistula did not adversely affect the results obtained. Conclusion Core fistulectomy associated with endorectal advancement flap repair is a safe and effective technique for any high trans-sphincteric and suprasphincteric fistula, with good results in terms of recurrence and anal continence. © 2000 British Journal of Surgery Society Ltd [source]


Required length of follow-up after transanal advancement flap repair of high transsphincteric fistulas

COLORECTAL DISEASE, Issue 7 2009
L. E. Mitalas
Abstract Objective, Repair of high perianal fistulas presents a major surgical challenge. Transanal advancement flap repair (TAFR) provides a useful tool in the treatment of these fistulas. Initially promising results have been reported. More recent studies indicate that TAFR fails in one out of three patients. The aim of the present study was to determine the appropriate length of follow-up needed to assess the healing rate after TAFR of high transsphincteric fistulas. Method, Between 1992 and 2000 a consecutive series of 80 patients with a high transsphincteric fistula of cryptoglandular origin underwent TAFR. Medical records of all patients were studied. The initial healing rate and the median healing time were assessed. The initial outcome was successful in 54 patients. The medical records revealed that only one of these patients presented with a recurrent fistula after 28 months. The other 53 patients were sent a questionnaire in 2006 aimed to determine whether they had any complaints or signs of a recurrent fistula. Results, The initial healing rate was 68%. The median healing time was 3.6 months. The completed questionnaire was returned by 48 patients. None of these patients reported any complaints or signs of a recurrent fistula. Median duration of follow-up in these patients was 92 months. Conclusion, At a median time interval of 3.6 months fistula healing was observed in 54 patients (68%). Only one patient (2%) encountered a recurrence. The length of follow-up can be restricted to the healing time. [source]