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肛瘘临床研究进展
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Abstract:
肛瘘是肛周直肠疾病中最常见的疾病之一。因其复杂性、复发性为临床上所重视研究。目前肛周瘘检查及治疗方法均有改进。本文以肛周瘘的疾病发展原因,术前检查操作以及治疗方式等方面进行现阶段的描述汇总进行系统综述,为肛瘘该疾病手术治疗提供参考意见。
Anal fistula is one of the most common perianal and rectal diseases. Because of its complexity and recurrence, it has attracted clinical research attention. Current examination and treatment meth-ods for perianal fistulas have been improved. This article summarizes the current description of the causes of perianal fistula disease development, preoperative examination procedures, and treat-ment methods and conducts a systematic review to provide reference opinions for the surgical treatment of anal fistula.
[1] | Charalampopoulos, A., Papakonstantinou, D., Bagias, G., et al. (2023) Surgery of Simple and Complex Anal Fistulae in Adults: A Review of the Literature for Optimal Surgical Outcomes. Cureus, 15, e35888.
https://doi.org/10.7759/cureus.35888 |
[2] | Kumar, L. and Emmanuel, A. (2017) Internal Anal Sphincter: Clinical Perspective. Surgeon, 15, 211-226.
https://doi.org/10.1016/j.surge.2016.10.003 |
[3] | Bazira, P.J. (2023) Anatomy of the Rectum and Anal Canal. Sur-gery, 41, 7-14.
https://doi.org/10.1016/j.mpsur.2022.11.002 |
[4] | Kim, M. (2023) [Perianal Fistula: An Overview]. Journal of the Korean Society of Radiology, 84, 565-585.
https://doi.org/10.3348/jksr.2023.0018 |
[5] | Ren, J., Bai, W., Gu, L., et al. (2023) Three-Dimensional Pelvic Ultra-sound Is a Practical Tool for the Assessment of Anal Fistula. BMC Gastroenterology, 23, Article No. 134. https://doi.org/10.1186/s12876-023-02715-5 |
[6] | ALsannaa, F., Saleem, R.B. and ALowayyid, J. (2023) Rectum Perforation Secondary to Ingested Chicken Bone Presenting as Peri-Anal Abscess: A Case Report. Cureus, 15, e49673. |
[7] | Wang, J. and Hu, G. (2022) Nomogram to Predict Radiation Enteritis in Cervical Squamous Cell Carcino-ma. Cancer Management and Research, 14, 3303-3311. https://doi.org/10.2147/CMAR.S383909 |
[8] | Whiteford, M.H. (2007) Perianal Abscess/Fistula Disease. Clinics in Colon and Rectal Surgery, 20, 102-109.
https://doi.org/10.1055/s-2007-977488 |
[9] | Kata, A. and Abelson, J.S. (2023) Anorectal Abscess. Clinics in Colon and Rectal Surgery.
https://doi.org/10.1055/s-0043-1777451 |
[10] | Janicke, D.M. and Pundt, M.R. (1996) Anorectal Disorders. Emer-gency Medicine Clinics of North America, 14, 757-788. https://doi.org/10.1016/S0733-8627(05)70278-9 |
[11] | Mateescu, T., Fulger, L., Tummala, D., et al. (2023) Explor-ing Health-Related Quality of Life in Patients with Anal Fistulas: A Comprehensive Study. Life, 13, Article 2008. https://doi.org/10.3390/life13102008 |
[12] | Spencer, J.A., Chapple, K., Wilson, D., et al. (1998) Outcome after Sur-gery for Perianal Fistula: Predictive Value of MR Imaging. American Journal of Roentgenology, 171, 403-406. https://doi.org/10.2214/ajr.171.2.9694464 |
[13] | Emile, S.H., Elfeki, H., El-Said, M., et al. (2021) Modification of Parks Classification of Cryptoglandular Anal Fistula. Diseases of the Colon & Rectum, 64, 446-458. https://doi.org/10.1097/DCR.0000000000001797 |
[14] | Charalampopoulos, A., Bagias, G., Bompetsi, G., et al. (2022) Anal Fistula of Crypto-Glandular Etiology: A Review of the Literature with a Step-by-Step Approach for Diag-nosis and Surgical Management. International Journal of Innovative Research in Medical Science, 7, 515-521. https://doi.org/10.23958/ijirms/vol07-i10/1508 |
[15] | Vogel, J.D., Johnson, E.K., Morris, A.M., et al. (2016) Clini-cal Practice Guideline for the Management of Anorectal Abscess, Fistula-in-Ano, and Rectovaginal Fistula. Diseases of the Colon & Rectum, 59, 1117-1133.
https://doi.org/10.1097/DCR.0000000000000733 |
[16] | Emile, S.H., Khafagy, W. and Elbaz, S.A. (2022) Impact of Number of Previous Surgeries on the Continence State and Healing after Repeat Surgery for Recurrent Anal Fistula. Journal of Visceral Surgery, 159, 206-211.
https://doi.org/10.1016/j.jviscsurg.2021.03.006 |
[17] | Mei, Z., Wang, Q., Zhang, Y., et al. (2019) Risk Factors for Recurrence after Anal Fistula Surgery: A Meta-Analysis. International Journal of Surgery, 69, 153-164. https://doi.org/10.1016/j.ijsu.2019.08.003 |
[18] | Emile, S.H. (2020) Recurrent Anal Fistulas: When, Why, and How to Manage? World Journal of Clinical Cases, 8, 1586-1591. https://doi.org/10.12998/wjcc.v8.i9.1586 |
[19] | Sugrue, J., Mantilla, N., Abcarian, A., et al. (2017) Sphincter-Sparing Anal Fistula Repair: Are We Getting Better? Diseases of the Colon & Rectum, 60, 1071-1077. https://doi.org/10.1097/DCR.0000000000000885 |
[20] | Varsamis, N., Kos-midis, C., Chatzimavroudis, G., et al. (2023) Preoperative Assessment of Perianal Fistulas with Combined Magnetic Resonance and Tridimensional Endoanal Ultrasound: A Prospective Study. Diagnostics, 13, Article 2851. https://doi.org/10.3390/diagnostics13172851 |
[21] | Tantiphlachiva, K., Sahakitrungruang, C., Pattanaarun, J., et al. (2019) Effects of Preoperative Endoanal Ultrasound on Functional Outcome after Anal Fistula Surgery. BMJ Open Gas-troenterology, 6, e000279.
https://doi.org/10.1136/bmjgast-2019-000279 |
[22] | Thipphavong, S., Costa, A.F., Ali, H.A., et al. (2019) Struc-tured Reporting of MRI for Perianal Fistula. Abdominal Radiology, 44, 1295-1305. https://doi.org/10.1007/s00261-018-1839-y |
[23] | Han, L., Chen, Y., Cheng, W., et al. (2021) Deep Learning-Based CT Image Characteristics and Postoperative Anal Function Restoration for Patients with Complex Anal Fistula. Journal of Healthcare Engineering, 2021, Article ID: 1730158. https://doi.org/10.1155/2021/1730158 |
[24] | Chang, Y.C., Tsai, P.H., Chou, Y.C., et al. (2021) Biomarkers Linked with Dynamic Changes of Renal Function in Asymptomatic and Mildly Symptomatic COVID-19 Patients. Journal of Personalized Medicine, 11, Article 432.
https://doi.org/10.3390/jpm11050432 |
[25] | Kim, H., Lee, D.I., Moon, S.K., et al. (2023) Typical MR Features and Interpretation of Perianal Fistulas in Patients with Crohn’s Disease. European Journal of Radiology, 167, Article ID: 111046.
https://doi.org/10.1016/j.ejrad.2023.111046 |
[26] | Akhoundi, N., Bozchelouei, J.K., Abrishami, A., et al. (2023) Comparison of MRI and Endoanal Ultrasound in Assessing Intersphincteric, Transsphincteric, and Suprasphincteric Per-ianal Fistula. Journal of Ultrasound in Medicine, 42, 2057-2064. https://doi.org/10.1002/jum.16225 |
[27] | Hamada, L.A.E., Dawoud, M.M., Abdallah, H.S. and Hefeda, M.M. (2022) Recent Advances of Magnetic Resonance Imaging in Evaluation of Recurrent Perianal Fistula. Journal of Advances in Medicine and Medical Research, 34, 49-62. https://doi.org/10.9734/jammr/2022/v34i1131364 |
[28] | Waidyasekera, R.H., Jayarajah, U. and Samarasekera, D.N. (2020) The Role of Routine Flexible Sigmoidoscopy in Patients Presenting with Fistula-in-Ano: An Observational Study. BMC Research Notes, 13, Article No 214.
https://doi.org/10.1186/s13104-020-05066-6 |
[29] | Xu, S., Zhang, L., Li, Z., et al. (2023) Enhancing Surgical Preci-sion: Unveiling the Impact of Preoperative Colonoscopy in Anal Fistula Patients. BMC Gastroenterology, 23, Article No. 442. https://doi.org/10.1186/s12876-023-03066-x |
[30] | Sugrue, J., Nordenstam, J., Abcarian, H., et al. (2017) Pathogenesis and Persistence of Cryptoglandular Anal Fistula: A Systematic Review. Techniques in Coloproctology, 21, 425-432. https://doi.org/10.1007/s10151-017-1645-5 |
[31] | Amato, A., Bottini, C., De Nardi, P., et al. (2020) Eval-uation and Management of Perianal Abscess and Anal Fistula: SICCR Position Statement. Techniques in Coloproctology, 24, 127-143. https://doi.org/10.1007/s10151-019-02144-1 |
[32] | Turner, G, A., Tham, N., Chandra, R., et al. (2023) Management of Acute Perianal Abscess: Is Surgeon Specialization Associated with Improved Outcomes? ANZ Journal of Surgery. https://doi.org/10.1111/ans.18836 |
[33] | Ommer, A., Herold, A., Berg, E., et al. (2011) Cryptoglandular Anal Fistulas. Deutsches ?rzteblatt International, 108, 707-713. https://doi.org/10.3238/arztebl.2011.0707 |
[34] | Garcia-Aguilar, J., Belmonte, C., Wong, W, D., et al. (1996) Anal Fistula Surgery. Factors Associated with Recurrence and Incontinence. Diseases of the Colon & Rectum, 39, 723-729. https://doi.org/10.1007/BF02054434 |
[35] | De Hous, N., Van Den Broeck, T. and De Gheldere, C. (2021) Fistulec-tomy and Primary Sphincteroplasty (FIPS) to Prevent Keyhole Deformity in Simple Anal Fistula: A Single-Center Ret-rospective Cohort Study. Acta Chirurgica Belgica, 121, 308-313. https://doi.org/10.1080/00015458.2020.1753151 |
[36] | Fritz, S., Reissfelder, C. and Bussen, D. (2023) Current Therapy of Cryptoglandular Anal Fistula: Gold Standards and Alternative Methods. Zentralblatt für Chirurgie, 148, 209-219. https://doi.org/10.1055/a-2049-9722 |
[37] | Cadeddu, F., Salis, F., Lisi, G., et al. (2015) Complex Anal Fistula Remains a Challenge for Colorectal Surgeon. International Journal of Colorectal Disease, 30, 595-603. https://doi.org/10.1007/s00384-014-2104-7 |
[38] | Huang, H., Ji, L., Gu, Y., et al. (2022) Efficacy and Safety of Sphincter-Preserving Surgery in the Treatment of Complex Anal Fistula: A Network Meta-Analysis. Frontiers in Sur-gery, 9, Article 825166.
https://doi.org/10.3389/fsurg.2022.825166 |
[39] | Ji, L., Zhang, Y., Xu, L., et al. (2020) Advances in the Treatment of Anal Fistula: A Mini-Review of Recent Five-Year Clinical Studies. Frontiers in Surgery, 7, Article 586891. https://doi.org/10.3389/fsurg.2020.586891 |
[40] | Rojanasakul, A., Booning, N., Huimin, L., et al. (2021) In-tersphincteric Exploration with Ligation of Intersphincteric Fistula Tract or Attempted Closure of Internal Opening for Acute Anorectal Abscesses. Diseases of the Colon & Rectum, 64, 438-445. https://doi.org/10.1097/DCR.0000000000001867 |
[41] | Malakorn, S., Sammour, T., Khomvilai, S., et al. (2017) Li-gation of Intersphincteric Fistula Tract for Fistula in Ano: Lessons Learned From A Decade of Experience. Diseases of the Colon & Rectum, 60, 1065-1070.
https://doi.org/10.1097/DCR.0000000000000880 |
[42] | Anaraki, F., Nikshoar, M.R., Ketabforoush, A., et al. (2023) Fistulectomy and Primary Sphincteroplasty in Complex Anal Fistula Treatment: A Hospital-Based Long-Term Fol-low-Up Study. Techniques in Coloproctology, 27, 145-152.
https://doi.org/10.1007/s10151-022-02722-w |
[43] | Omar, W., Alqasaby, A., Abdelnaby, M., et al. (2019) Drainage Seton versus External Anal Sphincter-Sparing Seton after Rerouting of the Fistula Tract in the Treatment of Complex Anal Fistula: A Randomized Controlled Trial. Diseases of the Colon & Rectum, 62, 980-987. https://doi.org/10.1097/DCR.0000000000001416 |
[44] | Yu, Q., Zhi, C., Jia, L., et al. (2022) Cutting Seton versus Decompression and Drainage Seton in the Treatment of High Complex Anal Fistula: A Randomized Controlled Trial. Scientific Reports, 12, Article No. 7838.
https://doi.org/10.1038/s41598-022-11712-9 |
[45] | An, Y., Chen, X., Tian, M., et al. (2023) Comparison of Clinical Outcomes of Anal Fistula Plug and Endoanal Advancement Flap Repair Treating the Complex Anal Fistula: A Systematic Review and Meta-Analysis. Updates in Surgery, 75, 2103-2115. https://doi.org/10.1007/s13304-023-01674-6 |
[46] | Vidon, M., Munoz-Bongrand, N., Lambert, J., et al. (2021) Long-Term Efficacy of Fibrin Glue Injection for Perianal Fistulas in Patients with Crohn’s Disease. Colorectal Disease, 23, 894-900. https://doi.org/10.1111/codi.15477 |
[47] | Giarratano, G., Shalaby, M., Toscana, C., et al. (2020) Vid-eo-Assisted Anal Fistula Treatment for Complex Anal Fistula: A Long-Term Follow-Up Study. Colorectal Disease, 22, 939-944. https://doi.org/10.1111/codi.15005 |
[48] | La Torre, M., La Greca, G., Fiori, E., et al. (2023) A Pilot Study on Staged Surgery by Delta Video-Assisted Anal Fistula Treatment (DVAAFT) for Complex Anal Fistula. Updates in Surgery, 75, 1867-1871.
https://doi.org/10.1007/s13304-023-01607-3 |
[49] | Reza, L., Gottgens, K., Kleijnen, J., et al. (2023) European Soci-ety of Coloproctology: Guidelines for Diagnosis and Treatment of Cryptoglandular Anal Fistula. Colorectal Disease, 26, 145-196. https://doi.org/10.1111/codi.16741 |
[50] | Arroyo, A., Sánchez-Guillén, L., Parra, P.A., et al. (2020) Pho-todynamic Therapy for the Treatment of Complex Anal Fistula. Lasers in Surgery and Medicine, 52, 503-508. https://doi.org/10.1002/lsm.23162 |
[51] | Tümer, H. and Bulbuloglu, G.C. (2023) A Comparison of Laser and Fistu-lotomy Techniques in the Treatment of Fistula-in-Ano. Cureus, 15, e37053. https://doi.org/10.7759/cureus.37053 |
[52] | Sutton, M.T., Fletcher, D., Ghosh, S.K., et al. (2016) Antimicrobial Properties of Mesenchymal Stem Cells: Therapeutic Potential for Cystic Fibrosis Infection, and Treatment. Stem Cells In-ternational, 2016, Article ID: 5303048.
https://doi.org/10.1155/2016/5303048 |
[53] | Alcayaga-Miranda, F., Cuenca, J. and Khoury, M. (2017) Antimicrobial Activity of Mesenchymal Stem Cells: Current Status and New Perspectives of Antimicrobial Peptide-Based Therapies. Frontiers in Immunology, 8, Article 339.
https://doi.org/10.3389/fimmu.2017.00339 |
[54] | Krasnodembskaya, A., Song, Y., Fang, X., et al. (2010) Antibacte-rial Effect of Human Mesenchymal Stem Cells Is Mediated in Part from Secretion of the Antimicrobial Peptide LL-37. Stem Cells, 28, 2229-2238.
https://doi.org/10.1002/stem.544 |
[55] | Chow, L., Johnson, V., Impastato, R., et al. (2020) Antibacterial Activity of Human Mesenchymal Stem Cells Mediated Directly by Constitutively Secreted Factors and Indirectly by Activation of Innate Immune Effector Cells. Stem Cells Translational Medicine, 9, 235-249. https://doi.org/10.1002/sctm.19-0092 |
[56] | Sheikholeslami, A., Fazaeli, H., Kalhor, N., et al. (2023) Use of Mes-enchymal Stem Cells in Crohn’s Disease and Perianal Fistulas: A Narrative Review. Current Stem Cell Research & Therapy, 18, 76-92.
https://doi.org/10.2174/1574888X16666210916145717 |