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    Wyświetlanie 1-5 z 5
    Tytuł:
    A novel model of acellular dermal matrix plug for anal fistula treatment. Report of a case and surgical consideration based on first utility in Poland
    Autorzy:
    Bobkiewicz, Adam
    Krokowicz, Łukasz
    Borejsza-Wysocki, Maciej
    Banasiewicz, Tomasz
    Powiązania:
    https://bibliotekanauki.pl/articles/1392974.pdf
    Data publikacji:
    2017
    Wydawca:
    Index Copernicus International
    Tematy:
    anal fistula
    biomaterial plug
    plug implantation
    Opis:
    Anal fistula (AF) is a pathological connection between anus and skin in its surroundings. The main reason for the formation of anal fistula is a bacterial infection of the glands within the anal crypts. One of the modern techniques for the treatment of fistulas that do not interfere with the sphincters consists in implantation of a plug made from collagen material. We are presenting the first Polish experience with a new model of biomaterial plug for the treatment of anal fistula. We also point out key elements of the procedure (both preoperative and intraoperative) associated with this method. In the authors’ opinion, the method is simple, safe and reproducible. Innovative shape of the plug minimizes the risk of its migration and rotation. It also perfectly blends with and adapts to the course and shape of the fistula canal, allowing it to become incorporated and overgrown with tissue in the fistula canal. The relatively short operation time, minor postoperative pain and faster convalescence are with no doubt additional advantages of the method. Long-term observation involving more patients is essential for evaluation of the efficacy of the treatment of fistulas with the new type of plug.
    Źródło:
    Polish Journal of Surgery; 2017, 89, 4; 52-55
    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
    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:
    Efficacy of Lift (Ligation of Intersphincteric Fistula Tract) for Complex and Recurrent Anal Fistulas - A Single-Center Experience and A Review of the Literature
    Autorzy:
    Romaniszyn, Michał
    Walega, Piotr Julian
    Nowak, Wojciech
    Powiązania:
    https://bibliotekanauki.pl/articles/1395977.pdf
    Data publikacji:
    2015-02-03
    Wydawca:
    Index Copernicus International
    Tematy:
    fistula-in-ano
    anal fistula
    ligation of intersphincteric fistula tract
    LIFT
    fistulotomy
    Opis:
    Ligation of intersphincteric fistula tract in treatment of anal fistulas (LIFT) is being said to have satisfactory results in short and long follow up, with low risk of complications. This study was designed to evaluate the results in patients with complex and recurrent fistulas in comparison with simple transsphincteric anal fistulas. The aim of the study was to present a single-center experience in LIFT procedure in treatment of both simple and complex anal fistulas, including recurrent fistulas, in comparison with a review of current literature. Material and methods. A series of 17 patients were qualified to LIFT procedure. 5 patients were treated for simple transsphincteric, 6 for complex fistulas, 6 with fistulas recurrent after fistulotomy. Median age was 47, most of the patients were male (16/17). Mean follow up was 11 months. Results. Mean operating time was 55 minutes counting from surgical site disinfection to final dressing of the wound. Of the 17 patients the overall success rate was 53%. As expected, best results were achieved in patients with simple fistulas (80% success rate), then complex (50%), and recurrent fistulas (only 33%). There were no early nor late complications of the surgery. Conclusion. As expected, in simple transsphincteric fistulas the results were satisfactory, taking into account low complication rate. Complex and recurrent fistulas seem to be risk factors of LIFT failure. The results are consistent with data published by other authors, based on the review of the current literature, and it seems there is still room for improvement, so further research is required.
    Źródło:
    Polish Journal of Surgery; 2014, 86, 11; 532-536
    0032-373X
    2299-2847
    Pojawia się w:
    Polish Journal of Surgery
    Dostawca treści:
    Biblioteka Nauki
    Artykuł
    Tytuł:
    Is rectoperineal fistula in anorectal malformations an ectopic anal canal with an internal anal sphincter?
    Czy przetoka odbytniczo-kroczowa w wadach odbytu i odbytnicy jest ektopowym kanałem odbytu ze zwieraczem wewnętrznym odbytu?
    Autorzy:
    Niedzielski, Jerzy
    Kobos, Józef
    Powiązania:
    https://bibliotekanauki.pl/articles/1032880.pdf
    Data publikacji:
    2011
    Wydawca:
    Łódzkie Towarzystwo Naukowe
    Tematy:
    anorectal malformations
    rectoperineal fistula
    internal anal
    sphincter
    anorectal manometry
    posterior sagittal approach.
    wady odbytu i odbytnicy
    przetoka odbytniczo-kroczowa
    zwieracz wewnętrzny odbytu
    manometria odbytnicza
    dostęp strzałkowy tylny
    Opis:
    Authors tried to determine the role of an internal anal sphincter (IAS) in patients with rectoperineal fistula undergoing PSARP, with or without IAS-saving procedure. Materials and methods: 20 girls and 6 boys with rectoperineal fistula undergoing PSARP between 1993-2008 were included in the study. An IAS-saving operation was performed in 19 children (73.1%), 17 girls and 2 boys, while 7 children underwent regular PSARP with resection of narrowed distal portion of fistula. Results: Functional postoperative result according to the „10” score was good (8-10 pts.) in all 26 children. There was no significant difference in RAP (16.3 vs. 16.9 vs. 17.2 cmH2O) and ACL (1.7 vs. 1.7 vs. 1.9 cm) values between children with and without preserved IAS and the reference group. Positive RAIR was observed in 13 of 19 children with preserved IAS, and in 2 of 7 patients after resection of IAS, but this incidence did not differ statistically (p = 0.095). The major functional disorder in the examined children was constipation, observed in 9 children after sphincter-saving procedure and in 2 patients after regular PSARP, but the difference was not significant (p = 0.658). Conclusions: An IAS is important, but not a decisive factor in fecal continence and IAS-saving procedures are associated with high incidence of constipation. Authors suggest that IAS can be spared, wherever it was possible, i.e. the fistula is wide (at least 8 mm) and it will not impair function of the neoanus.
    Autorzy podjęli próbę oceny roli zwieracza wewnętrznego odbytu (ZWO) u pacjentów z przetoką odbytniczo-kroczową po operacji wady odbytu metodą PSARP, z wycięciem lub oszczędzeniem ZWO. Materiały i metody: Badaniami objęto grupę 20 dziewczynek i 6 chłopców z przetoką odbytniczo-kroczową operowanych metodą PSARP w latach 1993-2008. Operację oszczędzającą ZWO przeprowadzono u 19 dzieci (73,1%), 17 dziewczynek i 2 chłopców, natomiast u 7 pacjentów wykonano operację PSARP z wycięciem zwężonego, dystalnego odcinka przetoki. Wyniki: Pooperacyjny wynik czynnościowy wg skali „10” był dobry (8-10 pkt.) u wszystkich 26 dzieci. Nie stwierdzono istotnej różnicy w wartościach RAP (16,3 vs. 16,9 vs. 17,2 cmH2O) i ACL (1,7 vs. 1,7 vs. 1,9 cm) u dzieci z i bez ZWO oraz grupą referencyjną. RAIR wywołano u 13 spośród 19 dzieci z zachowanym ZWO oraz u 2 spośród 7 pacjentów bez ZWO, bez różnicy statystycznej (p = 0,095). Najpoważniejszym zaburzeniem czynnościowym u dzieci były zaparcia obserwowane u 9 pacjentów z zachowanym ZWO i u 2 dzieci po klasycznej operacji PSARP, bez różnicy statystycznej (p = 0,658). Wnioski: ZWO jest ważnym, ale nie decydującym czynnikiem w mechanizmie trzymania stolca, a operacjom oszczędzającym ZWO towarzyszy wysoki odsetek zaparć w okresie pooperacyjnym. Autorzy sugerują oszczędzenie ZWO, jeżeli jest to możliwe, tzn. ujście przetoki jest szerokie (co najmniej 8 mm) i nie upośledza to czynności nowego odbytu.
    Źródło:
    Folia Medica Lodziensia; 2011, 38, 2; 167-176
    0071-6731
    Pojawia się w:
    Folia Medica Lodziensia
    Dostawca treści:
    Biblioteka Nauki
    Artykuł
      Wyświetlanie 1-5 z 5

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