Öz
Kaynakça
- Zhao WW, Yu J, Shu J, et al. Precise and comprehensive evaluation of perianal fistulas, classification and related complications using magnetic resonance imaging. Am J Transl Res. 2023;15(5):3674-3685.
- Limura E, Giordano P. Modern management of anal fistula. World J Gastroenterol. 2015;21(1):12-20.
- Włodarczyk M, Włodarczyk J, Sobolewska-Włodarczyk A, Trzciński R, Dziki Ł, Fichna J. Current concepts in the pathogenesis of cryptoglandular perianal fistula. J Int Med Res. 2021;49(2):300060520986669.
- Iqbal N, Tozer PJ, Fletcher J, et al. Getting the most out of MRI in perianal fistula: update on surgical techniques and radiological features that define surgical options. Clin Radiol. 2021;76(10):784.e17-e25.
- Vial M, Parés D, Pera M, Grande L. Faecal incontinence after seton treatment for anal fistulae with and without surgical division of internal anal sphincter: a systematic review. Colorectal Dis. 2010;12(3):172-178.
- Vo D, Phan C, Nguyen L, Le H, Nguyen T, Pham H. The role of magnetic resonance imaging in the preoperative evaluation of anal fistulas. Sci Rep. 2019;9(1):17947.
- Liang C, Lu Y, Zhao B, Du Y, Wang C, Jiang W. Imaging of anal fistulas: comparison of computed tomographic fistulography and magnetic resonance imaging. Korean J Radiol. 2014;15(6):712-723.
- Balcı S, Onur MR, Karaosmanoğlu AD, et al. MRI evaluation of anal and perianal diseases. Diagn Interv Radiol. 2019;25(1):21-27.
- Konan A, Onur MR, Özmen MN. The contribution of preoperative MRI to the surgical management of anal fistulas. Diagn Interv Radiol. 2018;24(6):321-327.
- Bayrak M, Altintaş Y, Alabaz Ö, Çelİktaş M. Contribution of preoperative magnetic resonance imaging in diagnosis and surgical treatment of anal fistula. Cukurova Med J. 2020;45(3):1210–1216
- O'Malley RB, Al-Hawary MM, Kaza RK, Wasnik AP, Liu PS, Hussain HK. Rectal imaging: part 2, Perianal fistula evaluation on pelvic MRI--what the radiologist needs to know. AJR Am J Roentgenol. 2012;199(1):W43-W53.
- Sahni VA, Ahmad R, Burling D. Which method is best for imaging of perianal fistula?. Abdom Imaging. 2008;33(1):26-30.
- Buchanan G, Halligan S, Williams A, et al. Effect of MRI on clinical outcome of recurrent fistula-in-ano. Lancet. 2002;360(9346):1661-1662.
- Morris J, Spencer JA, Ambrose NS. MR imaging classification of perianal fistulas and its implications for patient management. Radiographics. 2000;20(3):623-637.
- Liu X, Wang Z, Ren H, Wang Z, Li J. Accuracy of magnetic resonance imaging in defining dentate line in anal fistula. BMC Med Imaging. 2022;22(1):201.
- Madany AH, Murad A, Kabbash M, Ahmed H. Magnetic resonance imaging in the workup of patients with perianal fistulas. Egypt J Radiol Nucl Med. 2023;54:1-16.
- Singh K, Singh N, Thukral C, Singh KP, Bhalla V. Magnetic resonance imaging (MRI) evaluation of perianal fistulae with surgical correlation. J Clin Diagn Res. 2014;8(6):RC01-RC4.
- Jacob TJ, Perakath B, Keighley MR. Surgical intervention for anorectal fistula. Cochrane Database Syst Rev. 2010;(5):CD006319.
- Lei C, Li C, Liu M, Song Z, Li C, Liu Z. Proximal anal sinus resection as an alternative to fistulectomy and seton for reducing recurrence of anal fistulas: a retrospective study. Ann Palliat Med. 2021;10(12):12273-12279.
- Mei Z, Wang Q, Zhang Y, et al. Risk Factors for Recurrence after anal fistula surgery: a meta-analysis. Int J Surg. 2019;69:153-164.
Comparison of preoperative MRI and surgical findings in perianal fistulas and factors affecting recurrence
Öz
Aims: Anal fistula occurs most commonly when the anal glands become obstructed and infected in the intersphincteric plane. Although it has a high recurrence rates, its treatment is surgical. Magnetic resonance imaging (MRI) is the gold standard for accurate preoperative evaluation of the patient and detection of the relationship to the muscle groups that provide continence. The aim of this study was to evaluate the compatibility of MRI with surgery and to determine the parameters effective on recurrence.
Methods: Primary perianal fistulas with MRI between 2016 and 2023 were retrospectively evaluated. Patient demographics were documented. Fistula classifications according to MRI findings, abscess locations, internal and external opening regions on MRI were compared with surgical findings. The surgical procedures performed were documented. Univariate and multivariate evaluations of recurrence performed by Cox regression analysis. Disease-free survival data were analyzed.
Results: A total of 180 cases with a mean age of 43.75±12.57 years were included in the study. At the end of MRI, there were 69 (38.3%) cases with an fistula external orifice > 3 cm. The largest group in Parks classification were intersphincteric patients with 127 (66.7%), 52 (28.9%) of the patients were in the complex group. The level of agreement between surgery and MRI internal opening was 13.4% and statistically significant (Kappa coefficient of agreement 0.134; p<0.01). Total recurrence was observed in 33(18.3%) patients. Recurrence was statistically significant in patients with external orifice >3 cm, transsphincteric, complex and patients requiring loose seton in surgery (p=0.001, p=0.001, p=0.001, p=0.001, p=0.007; p<0.01 respectively).
Conclusion: In our study, we found that the recurrence rate was higher in patients with an external orifice of more than 3 cm, transsphincteric, 3-4th degree complex fistulas, and patients with loose setons.
Anahtar Kelimeler
Anal fistula magnetic resonance imaging recurrence classification
Kaynakça
- Zhao WW, Yu J, Shu J, et al. Precise and comprehensive evaluation of perianal fistulas, classification and related complications using magnetic resonance imaging. Am J Transl Res. 2023;15(5):3674-3685.
- Limura E, Giordano P. Modern management of anal fistula. World J Gastroenterol. 2015;21(1):12-20.
- Włodarczyk M, Włodarczyk J, Sobolewska-Włodarczyk A, Trzciński R, Dziki Ł, Fichna J. Current concepts in the pathogenesis of cryptoglandular perianal fistula. J Int Med Res. 2021;49(2):300060520986669.
- Iqbal N, Tozer PJ, Fletcher J, et al. Getting the most out of MRI in perianal fistula: update on surgical techniques and radiological features that define surgical options. Clin Radiol. 2021;76(10):784.e17-e25.
- Vial M, Parés D, Pera M, Grande L. Faecal incontinence after seton treatment for anal fistulae with and without surgical division of internal anal sphincter: a systematic review. Colorectal Dis. 2010;12(3):172-178.
- Vo D, Phan C, Nguyen L, Le H, Nguyen T, Pham H. The role of magnetic resonance imaging in the preoperative evaluation of anal fistulas. Sci Rep. 2019;9(1):17947.
- Liang C, Lu Y, Zhao B, Du Y, Wang C, Jiang W. Imaging of anal fistulas: comparison of computed tomographic fistulography and magnetic resonance imaging. Korean J Radiol. 2014;15(6):712-723.
- Balcı S, Onur MR, Karaosmanoğlu AD, et al. MRI evaluation of anal and perianal diseases. Diagn Interv Radiol. 2019;25(1):21-27.
- Konan A, Onur MR, Özmen MN. The contribution of preoperative MRI to the surgical management of anal fistulas. Diagn Interv Radiol. 2018;24(6):321-327.
- Bayrak M, Altintaş Y, Alabaz Ö, Çelİktaş M. Contribution of preoperative magnetic resonance imaging in diagnosis and surgical treatment of anal fistula. Cukurova Med J. 2020;45(3):1210–1216
- O'Malley RB, Al-Hawary MM, Kaza RK, Wasnik AP, Liu PS, Hussain HK. Rectal imaging: part 2, Perianal fistula evaluation on pelvic MRI--what the radiologist needs to know. AJR Am J Roentgenol. 2012;199(1):W43-W53.
- Sahni VA, Ahmad R, Burling D. Which method is best for imaging of perianal fistula?. Abdom Imaging. 2008;33(1):26-30.
- Buchanan G, Halligan S, Williams A, et al. Effect of MRI on clinical outcome of recurrent fistula-in-ano. Lancet. 2002;360(9346):1661-1662.
- Morris J, Spencer JA, Ambrose NS. MR imaging classification of perianal fistulas and its implications for patient management. Radiographics. 2000;20(3):623-637.
- Liu X, Wang Z, Ren H, Wang Z, Li J. Accuracy of magnetic resonance imaging in defining dentate line in anal fistula. BMC Med Imaging. 2022;22(1):201.
- Madany AH, Murad A, Kabbash M, Ahmed H. Magnetic resonance imaging in the workup of patients with perianal fistulas. Egypt J Radiol Nucl Med. 2023;54:1-16.
- Singh K, Singh N, Thukral C, Singh KP, Bhalla V. Magnetic resonance imaging (MRI) evaluation of perianal fistulae with surgical correlation. J Clin Diagn Res. 2014;8(6):RC01-RC4.
- Jacob TJ, Perakath B, Keighley MR. Surgical intervention for anorectal fistula. Cochrane Database Syst Rev. 2010;(5):CD006319.
- Lei C, Li C, Liu M, Song Z, Li C, Liu Z. Proximal anal sinus resection as an alternative to fistulectomy and seton for reducing recurrence of anal fistulas: a retrospective study. Ann Palliat Med. 2021;10(12):12273-12279.
- Mei Z, Wang Q, Zhang Y, et al. Risk Factors for Recurrence after anal fistula surgery: a meta-analysis. Int J Surg. 2019;69:153-164.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Genel Cerrahi |
| Bölüm | Orijinal Makale |
| Yazarlar | |
| Erken Görünüm Tarihi | 28 Ekim 2023 |
| Yayımlanma Tarihi | 29 Ekim 2023 |
| Yayımlandığı Sayı | Yıl 2023 Cilt: 6 Sayı: 6 |
Üniversitelerarası Kurul (ÜAK) Eşdeğerliği: Ulakbim TR Dizin'de olan dergilerde yayımlanan makale [10 PUAN] ve 1a, b, c hariç uluslararası indekslerde (1d) olan dergilerde yayımlanan makale [5 PUAN]
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Not: Dergimiz WOS indeksli değildir ve bu nedenle Q olarak sınıflandırılmamıştır.
Yüksek Öğretim Kurumu (YÖK) kriterlerine göre yağmacı/şüpheli dergiler hakkındaki kararları ile yazar aydınlatma metni ve dergi ücretlendirme politikasını tarayıcınızdan indirebilirsiniz. https://dergipark.org.tr/tr/journal/2316/file/4905/show
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