Long-term outcome following mucosal advancement flap for high perianal fistulas and fistulotomy for low perianal fistulas Recurrent perianal fistulas: failure of treatment or recurrent patient disease?

S.J. van der Hagen, C.G. Baeten, P.B. Soeters, W.G. van Gemert

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Abstract

Background: In this study, we determined the long-term outcome of perianal fistulas treated with mucosal advancement flap (MF) or fistulotomy (FT). Methods: One hundred three patients with perianal fistulas were treated by MF for high fistulas or FT for low fistulas and were retrospectively assessed by case-note review and examined at the out-patient clinic. The localization and time of recurrence of the fistula were recorded. Results: Forty-one patients [median follow-up of 72 months (range 48-99)] were treated by an MF, and 62 patients [median follow up of 75 months (range 48-99)] were treated by FT. After 12, 48, and 72 months, the fistula had recurred in 9 (22%), 26 (63%), and 26 (63%) patients of the MF group and in 4 (7%), 16 (26%), and 24 (39%) patients of the FT group, respectively. Eighteen (69%) of the recurrences in the MF group and ten (33%) of the FT group occurred within 24 months after surgery (p=0.01). Four (15%) of the recurrences in the MF group and 13 (54%) of the recurrences in the FT group were present in a different localization (p=0.007). Conclusion: The success rate of both FT and MF techniques decreases with time. Recurrence appears to be caused by failure of treatment and by recurrent patient disease.
Original languageEnglish
Pages (from-to)784-790
JournalInternational Journal of Colorectal Disease
Volume21
Issue number8
DOIs
Publication statusPublished - 1 Jan 2006

Cite this

@article{1ddcfcfa946949b5a6691ef5ca83afed,
title = "Long-term outcome following mucosal advancement flap for high perianal fistulas and fistulotomy for low perianal fistulas Recurrent perianal fistulas: failure of treatment or recurrent patient disease?",
abstract = "Background: In this study, we determined the long-term outcome of perianal fistulas treated with mucosal advancement flap (MF) or fistulotomy (FT). Methods: One hundred three patients with perianal fistulas were treated by MF for high fistulas or FT for low fistulas and were retrospectively assessed by case-note review and examined at the out-patient clinic. The localization and time of recurrence of the fistula were recorded. Results: Forty-one patients [median follow-up of 72 months (range 48-99)] were treated by an MF, and 62 patients [median follow up of 75 months (range 48-99)] were treated by FT. After 12, 48, and 72 months, the fistula had recurred in 9 (22{\%}), 26 (63{\%}), and 26 (63{\%}) patients of the MF group and in 4 (7{\%}), 16 (26{\%}), and 24 (39{\%}) patients of the FT group, respectively. Eighteen (69{\%}) of the recurrences in the MF group and ten (33{\%}) of the FT group occurred within 24 months after surgery (p=0.01). Four (15{\%}) of the recurrences in the MF group and 13 (54{\%}) of the recurrences in the FT group were present in a different localization (p=0.007). Conclusion: The success rate of both FT and MF techniques decreases with time. Recurrence appears to be caused by failure of treatment and by recurrent patient disease.",
author = "{van der Hagen}, S.J. and C.G. Baeten and P.B. Soeters and {van Gemert}, W.G.",
year = "2006",
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TY - JOUR

T1 - Long-term outcome following mucosal advancement flap for high perianal fistulas and fistulotomy for low perianal fistulas Recurrent perianal fistulas: failure of treatment or recurrent patient disease?

AU - van der Hagen, S.J.

AU - Baeten, C.G.

AU - Soeters, P.B.

AU - van Gemert, W.G.

PY - 2006/1/1

Y1 - 2006/1/1

N2 - Background: In this study, we determined the long-term outcome of perianal fistulas treated with mucosal advancement flap (MF) or fistulotomy (FT). Methods: One hundred three patients with perianal fistulas were treated by MF for high fistulas or FT for low fistulas and were retrospectively assessed by case-note review and examined at the out-patient clinic. The localization and time of recurrence of the fistula were recorded. Results: Forty-one patients [median follow-up of 72 months (range 48-99)] were treated by an MF, and 62 patients [median follow up of 75 months (range 48-99)] were treated by FT. After 12, 48, and 72 months, the fistula had recurred in 9 (22%), 26 (63%), and 26 (63%) patients of the MF group and in 4 (7%), 16 (26%), and 24 (39%) patients of the FT group, respectively. Eighteen (69%) of the recurrences in the MF group and ten (33%) of the FT group occurred within 24 months after surgery (p=0.01). Four (15%) of the recurrences in the MF group and 13 (54%) of the recurrences in the FT group were present in a different localization (p=0.007). Conclusion: The success rate of both FT and MF techniques decreases with time. Recurrence appears to be caused by failure of treatment and by recurrent patient disease.

AB - Background: In this study, we determined the long-term outcome of perianal fistulas treated with mucosal advancement flap (MF) or fistulotomy (FT). Methods: One hundred three patients with perianal fistulas were treated by MF for high fistulas or FT for low fistulas and were retrospectively assessed by case-note review and examined at the out-patient clinic. The localization and time of recurrence of the fistula were recorded. Results: Forty-one patients [median follow-up of 72 months (range 48-99)] were treated by an MF, and 62 patients [median follow up of 75 months (range 48-99)] were treated by FT. After 12, 48, and 72 months, the fistula had recurred in 9 (22%), 26 (63%), and 26 (63%) patients of the MF group and in 4 (7%), 16 (26%), and 24 (39%) patients of the FT group, respectively. Eighteen (69%) of the recurrences in the MF group and ten (33%) of the FT group occurred within 24 months after surgery (p=0.01). Four (15%) of the recurrences in the MF group and 13 (54%) of the recurrences in the FT group were present in a different localization (p=0.007). Conclusion: The success rate of both FT and MF techniques decreases with time. Recurrence appears to be caused by failure of treatment and by recurrent patient disease.

U2 - 10.1007/s00384-005-0072-7

DO - 10.1007/s00384-005-0072-7

M3 - Article

VL - 21

SP - 784

EP - 790

JO - International Journal of Colorectal Disease

JF - International Journal of Colorectal Disease

SN - 0179-1958

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