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World J Gastroenterol. 2011 Jul 28;17(28):3297-9. doi: 10.3748/wjg.v17.i28.3297.

Why do we have to review our experience in managing cases with idiopathic fistula-in-ano regularly?

Author information

1
Department of Medical and Surgical Critical Care, Section of General Surgery, University of Florence, Florence 50100, Italy.

Abstract

"Why do we have to review our experience in managing idiopathic fistula-in-ano regularly?" In order to answer this apparently simple question, we reviewed our clinical and surgical cases and most important relevant literature to find a rational and scientific answer. It would appear that whatever method you adopt in fistula management, there is a price to pay regarding either rate of recurrence (higher with conservative methods) or impairment of continence (higher with traditional surgery). Since, at the moment, reliable data to identify a treatment as a gold standard in the management of anal fistulas are lacking, the correct approach to this condition must consider all the anatomic and clinicopathological aspects of the disease; this knowledge joined to an eclectic attitude of the surgeon, who should be familiar with different types of treatment, is the only guarantee for a satisfactory treatment. As a conclusion, it is worthwhile to remember that adequate initial treatment significantly reduces recurrence, which, when it occurs, is usually due to failure to recognise the tract and primary opening at the initial operation.

KEYWORDS:

Anal abscess; Anal cryptoglandular infections; Anal fistula treatment; Recurrent fistula-in-ano; Surgery of fistula-in-ano

PMID:
21876617
PMCID:
PMC3160533
DOI:
10.3748/wjg.v17.i28.3297
[Indexed for MEDLINE]
Free PMC Article
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