High complex anal fistula managed by the modified transanal opening of the intersphincteric space via the inter-sphincteric approach: A case report
Year: 2024
Type: article
Study design: Case Report
Abstract: BACKGROUND: High complex anal fistulas are epithelialized tunnels, with the main fistula piercing above the deep external sphincter and the internal opening approaching the dentate line. Conventional surgical procedures for high complex anal fistulas remove most of the external sphincter and damage the anorectal ring. Postoperative loss of anal function can cause physical and mental damage. Transanal opening of the intersphincteric space (TROPIS) is an effective procedure that completely preserves the external anal sphincter. However, its clinical application is limited by challenges in the localization of the internal opening of a fistula and the high risk of complications. On the basis of our clinical experience, we modified the TROPIS procedure for the treatment of treating high complex anal fistulas. CASE SUMMARY: A patient with a high complex anal fistula located above the anorectal ring underwent modified TROPIS, which involved sepsis drainage and identification of the internal opening in the intersphincteric space. The patient with the high complex anal fistula recovered well postoperatively, without any postoperative complications or anal dysfunction. Anal function returned to normal after 17 months of follow-up. CONCLUSION: the intersphincteric approach is an alternative sphincter-preserving treatment for high complex anal fistulas.
Source: World Journal of Radiology
Authors: Ya-Qun Wang, Yan Wang, Xiao-Feng Jia, Qiao-Jing Yan, Xue-Ping Zheng
Institution: Nanjing University of Chinese Medicine
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4403749374