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Wyszukujesz frazę "surgical treatment of fistulas" wg kryterium: Wszystkie pola

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    Wyświetlanie 1-3 z 3
    Tytuł:
    Cell therapy in surgical treatment of fistulas. Preliminary results
    Autorzy:
    Piejko, Marcin
    Romaniszyn, Michał
    Borowczyk-Michałowska, Julia
    Drukała, Justyna
    Wałęga, Piotr
    Powiązania:
    https://bibliotekanauki.pl/articles/1393600.pdf
    Data publikacji:
    2017
    Wydawca:
    Index Copernicus International
    Tematy:
    anal fistula
    stem cell-based therapy
    recurrent fistula
    regenerative medicine
    rectovaginal fistula
    Opis:
    Risk of recurrence after surgical treatment of a recurrent fistula is up to 50%. It has be known that more aggressive surgical treatment is associated with a high risk of anal sphincter damage and leads to incontinence. Several studies have been designed to elaborate minimally invasive treatment of rectovaginal and anal fistulas. The properties of Adipose-derived Stem Cells (ASC) significantly enhance a natural healing potency. Here, we present our experience with combined surgical and cell therapy in the treatment of fistulas. Materials and Methods: Four patients were enrolled in our study after unsuccessful treatments in the past – patients 1-3 with rectovaginal fistulas including two women after graciloplasty, and patient 4 - a male with complex perianal fistula. Adipose tissue was obtained from subcutaneous tissue. ASCs were isolated, cultured up to 10+/-2 mln cells and injected into the walls of fistulas. Follow-up physical examination and anoscopy were performed at 1, 4, 8, and 12 weeks, 6 and 12 months after implantation. Results: Up to 8 weeks after ASC implantation, symptoms of fistulas’ tracts disappeared. At 8 weeks, in patients 1-3, communication between vaginal and rectal openings was closed and at 12-16 w. intestinal continuity was restored in patient 3 and 4. After a 6-month follow-up, the fistula tract of patient 4 was closed. Up to 12 m. after ASC implantation no recurrences or adverse events were observed. Conclusion: ASCs combined with surgical pre-treated fistula tracts were used in four patients. All of them were healed. This encouraging result needs further trials to evaluate the clinical efficiency and the cost-effectiveness ratio.
    Źródło:
    Polish Journal of Surgery; 2017, 89, 3; 48-51
    0032-373X
    2299-2847
    Pojawia się w:
    Polish Journal of Surgery
    Dostawca treści:
    Biblioteka Nauki
    Artykuł
    Tytuł:
    Statement of the expert group on the current practice and prospects for the treatment of complex perirectal fistulas in the course of Crohn’s disease
    Autorzy:
    Banasiewicz, Tomasz
    Eder, Piotr
    Rydzewska, Grażyna
    Reguła, Jarosław
    Dobrowolska, Agnieszka
    Durlik, Marek
    Wallner, Grzegorz
    Powiązania:
    https://bibliotekanauki.pl/articles/1392381.pdf
    Data publikacji:
    2019
    Wydawca:
    Index Copernicus International
    Tematy:
    Crohn's disease
    perianal fistula
    surgical treatment of fistulas
    biological treatment
    stem cells
    Opis:
    Perirectal fistulas in the course of Crohn’s disease (CD) constitute an important problem in this group of patients. They are observed in a vast majority of patients with involvement through colorectal inflammation. Perirectal fistulas in CD present a great diagnostic and therapeutic challenge due to the intensified clinical symptoms and worse prognosis than in the case of crypt originating fistulas. The condition for implementation of effective treatment of perirectal fistulas in the course of CD is the correct diagnosis, defining the anatomy of fistulas, presence of potential stenoses and inflammation in the gastrointestinal tract. Treatment of these fistulas is difficult and requires close cooperation between the colorectal surgeon and the gastroenterologist. The combination of surgical and pharmacological treatment has higher efficacy compared to surgical treatment or pharmacotherapy alone. In conservative treatment, aminosalicylates and steroids are of minor importance, while chemotherapeutics, antibiotics, and thiopurines find application in daily clinical practice. TNF-α neutralizing antibodies such as infliximab (IFX), adalimumab (ADA) or certolizumab (CER) prove to be the most effective. Surgical treatment may be provided as ad hoc; in this case, drainage procedures are recommended, usually with leaving a loose seton. Planned procedures consist in the excision of fistulas (simple fistulas) or performing more complex procedures, such as advancement flaps or ligation of the intersphincteric fistula tract Surgical measures can be complemented by the use of video technology (video-assisted anal fistula treatment VAAFT) or vacuum therapy. In extreme cases, it may be necessary to create the stoma. Treatment of perirectal fistulas includes adhesives or so-called plugs. High hopes may be associated with the introduction of stem cells into clinical practice, which is the administration of non-hematopoietic multipotent cells to the fistulas to induce the phenomenon of immunomodulation and tissue healing.
    Źródło:
    Polish Journal of Surgery; 2019, 91, 1; 38-46
    0032-373X
    2299-2847
    Pojawia się w:
    Polish Journal of Surgery
    Dostawca treści:
    Biblioteka Nauki
    Artykuł
    Tytuł:
    VAAFT: a new minimally invasive method in the diagnostics and treatment of anal fistulas – initial results
    Autorzy:
    Wałęga, Piotr
    Romaniszyn, Michał
    Nowak, Wojciech
    Powiązania:
    https://bibliotekanauki.pl/articles/1395691.pdf
    Data publikacji:
    2014-01-01
    Wydawca:
    Index Copernicus International
    Tematy:
    anal fistula
    surgical treatment
    minimally invasive procedure
    VAAFT
    Opis:
    The aim of the study was to present our own experience in the treatment of anal fistulas by means of VAAFT (Video-Assisted Anal Fistula Treatment). Material and methods. Twenty patients were qualified for the VAAFT procedure. All were subjected to diagnostics. Two patients after the diagnostic stage underwent classical fistula surgery. The remaining 18 patients were subjected to the full procedure (diagnostic fistuloscopy, supply of the internal ostium, and coagulation of the fistula canal). The mean observation period was 10 months. Results. In most cases the trans-sphincter fistula was observed during the diagnostic phase, including three with additional fluid compartments. There was one intersphincteric fistula. Considering the 18 patients subjected to the full VAAFT procedure the internal ostium was supplied by means of an advancement flap in 3 cases, while in 11 by means of a mattress suture, including one with additional tissue glue. In 4 cases the internal ostium was tightly covered by mucosa. Surgical complications were not observed during the procedure. During further observation a permanent fistula was observed in 4 (22%) patients, and in two (17%), recurrence of anal fistula. In the remaining 12 patients one observed healing without fistula recurrence. Complications were not observed, including stool and gas control deterioration (based on the FISI scoring). Conclusions. The VAAFT method does not affect sphincter efficiency, no intra- and postoperative complications were observed. As compared to other minimally invasive procedures a comparable recovery rate is observed without the risk of incontinence. It is the only method enabling the intraoperative identification of the internal ostium and fistula canal under visual control. Initial optimistic results require further investigations on a larger group of patients.
    Źródło:
    Polish Journal of Surgery; 2014, 86, 1; 7-10
    0032-373X
    2299-2847
    Pojawia się w:
    Polish Journal of Surgery
    Dostawca treści:
    Biblioteka Nauki
    Artykuł
      Wyświetlanie 1-3 z 3

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