A New, Conservative Treatment for Perianal Fistula that May Halve the Need for Surgical Intervention: Case Series
| Autor: | Tatiana Prieto-Puga Arjona, Jose Manuel Hernández González, Juan Doblas Fernández, Francisco Javier Pérez Lara, Francisco Javier Moya Donoso |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Anal fistula
Surgical team medicine.medical_specialty business.industry Conservative Treatment medicine.disease Surgery Sphincter preservation Conservative treatment 03 medical and health sciences Treatment Outcome 0302 clinical medicine Perianal fistula Recurrence 030220 oncology & carcinogenesis Intervention (counseling) Humans Rectal Fistula Medicine 030211 gastroenterology & hepatology business |
| Zdroj: | Surgical Innovation. 29:50-55 |
| ISSN: | 1553-3514 1553-3506 |
| DOI: | 10.1177/15533506211015196 |
| Popis: | Purpose. In the last two decades, many sphincter preservation techniques have been proposed for the treatment of anal fistula. Since 2011, our surgical team has treated fistulas by sealing them with platelet-rich fibrin (PRF). This is performed actually as an outpatient process, without anaesthesia. Methods. Patients were treated with PRF sealant, during the period June 2012–March 2017. The fibrin preparation is applied in the fistulous tract, with no need for any type of anaesthesia, and so the patient can go home immediately afterwards, without further observation. Results. After an average follow-up of 26.49 months, the perianal fistula had healed completely in 52.86% of the patients (n = 37), who each received an average of 1.92 sealant operations. In another 10 cases, the sealing was initially successful, but a relapse occurred during the follow-up period. Conclusion. The outpatient treatment of perianal fistula with PRF is totally harmless, is very low cost and achieves very acceptable results. In our opinion, therefore, this could be considered an appropriate initial treatment for perianal fistula, with surgical treatment being reserved if this approach is unsuccessful, thereby avoiding many complications and producing significant economic savings for the health system. |
| Databáze: | OpenAIRE |
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