Pathogenesis and persistence of cryptoglandular anal fistula: a systematic review
| Autor: | Jeremy Sugrue, Herand Abcarian, Amelia Bartholomew, Johan Nordenstam, Anders Mellgren, Philip J. Tozer, Joel L. Schwartz |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Male Anal fistula medicine.medical_specialty Pathology Epithelial-Mesenchymal Transition Fistula Anal Canal Gut flora Proinflammatory cytokine Pathogenesis 03 medical and health sciences 0302 clinical medicine Crohn Disease medicine Humans Rectal Fistula biology business.industry Perianal Abscess Gastroenterology Histology Middle Aged medicine.disease biology.organism_classification Colorectal surgery Gastrointestinal Microbiome 030220 oncology & carcinogenesis Chronic Disease Cytokines Female 030211 gastroenterology & hepatology Surgery business |
| Zdroj: | Techniques in Coloproctology. 21:425-432 |
| ISSN: | 1128-045X 1123-6337 |
| Popis: | Anal fistulas continue to be a problem for patients and surgeons alike despite scientific advances. While patient and anatomical characteristics are important to surgeons who are evaluating patients with anal fistulas, their development and persistence likely involves a multifaceted interaction of histological, microbiological, and molecular factors. Histological studies have shown that anal fistulas are variably epithelialized and are surrounded by dense collagen tissue with pockets of inflammatory cells. Yet, it remains unknown if or how histological differences impact fistula healing. The presence of a perianal abscess that contains gut flora commonly leads to the development of anal fistula. This implies a microbiological component, but bacteria are infrequently found in chronic fistulas. Recent work has shown an increased expression of proinflammatory cytokines and epithelial to mesenchymal cell transition in both cryptoglandular and Crohn's perianal fistulas. This suggests that molecular mechanisms may also play a role in both fistula development and persistence. The aim of this study was to examine the histological, microbiological, molecular, and host factors that contribute to the development and persistence of anal fistulas. |
| Databáze: | OpenAIRE |
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