- Primary perianal adenocarcinoma of intestinal type - a new proposed entity. [Journal Article]
- HHistopathology 2018 Feb 21
- CONCLUSIONS: The name 'primary perianal adenocarcinoma of intestinal type' is proposed for this previously unrecognised subtype of perineal neoplasia. Awareness of its distinct existence - by recognising its intestinal morphology and immunophenotype while excluding metastasis from the intestinal tract - should help collate data to determine its specific prognosis and to formulate its best management. This article is protected by copyright. All rights reserved.
- [Perianal inflammatory diseases : Classification and imaging]. [Review]
- RRadiologe 2018 Feb 20
- During the past 30 years, classifications and scoring systems have been developed in order to evaluate and objectify the degree and activity of anorectal fistulas. Only a few of these disease-specifi...
During the past 30 years, classifications and scoring systems have been developed in order to evaluate and objectify the degree and activity of anorectal fistulas. Only a few of these disease-specific instruments have been adopted into daily clinical routine. Generally, clinicians tend to use global medical judgement rather than numeric activity indices, which often seem complex and time consuming. Activity scores in Crohn disease, however, appeared to be very useful in clinical trials regarding evaluation of therapy response. Thus, activity indices must be simple and reproducible. The years 1976 and 1995, in which the Parks Classification and Perianal Disease Activity Index (PDAI) were established, can be considered milestone years for classifying patients with anorectal fistulizing disease. These instruments should be recognized at present as the gold standard for evaluating the complexity as well as the severity of anorectal fistulas and perianal Crohn disease.
- Clinical characteristics and long-term prognosis of elderly-onset Crohn's disease. [Journal Article]
- SJScand J Gastroenterol 2018 Feb 19; :1-9
- CONCLUSIONS: EOCD may have a better clinical course than MOCD and YOCD, as demonstrated by the similar risk for intestinal resection despite the less frequent use of thiopurines.
- Micro-fragmented adipose tissue injection for the treatment of complex anal fistula: a pilot study accessing safety and feasibility. [Journal Article]
- TCTech Coloproctol 2018 Feb 16
- CONCLUSIONS: The injection of autologous, micro-fragmented and minimally manipulated adipose tissue associated with closure of the internal opening is a safe, feasible and reproducible procedure and may enhance complex anal fistula healing.
- Complex Perianal Fistula. [Journal Article]
- CECir Esp 2018 Feb 12
- Pilonidal disease mimicking anterior anal fistula and associated with posterior anal fistula: a two-step surgery. Case report. [Journal Article]
- GCG Chir 2017 Nov-Dec; 38(6):313-317
- CONCLUSIONS: This misdiagnosed pilonidal disease created in our clinical report a true challenge. Our goal was to eliminate as much disease as possible, but also to avoid major complications or recurrences. We refused an aggressive approach and chose a two-step surgery, with in the first approach not only a demolitive time but also a reconstruction to facilitate healing, and in the second time the complete eradication of the pathology.
- Developing a core outcome set for fistulising perianal Crohn's disease. [Journal Article]
- GutGut 2018 Feb 03
- CONCLUSIONS: A fistulising pCD COS has been produced by all key stakeholders. Application of the COS will reduce heterogeneity in outcome reporting, thereby facilitating more meaningful comparisons between treatments, data synthesis and ultimately benefit patient care.
- [A Case of More Than Five-Year Survival of Carcinoma Associated with Anal Fistula Effectively Treated by Combined Modality Therapy]. [Journal Article]
- GTGan To Kagaku Ryoho 2017; 44(12):1754-1756
- The patient was a 56-year-old man who presented with perianal pain and a perianal abscess. After admission, he underwent debridement and colostomy due to poor control of the perianal abscess. Followi...
The patient was a 56-year-old man who presented with perianal pain and a perianal abscess. After admission, he underwent debridement and colostomy due to poor control of the perianal abscess. Following a biopsy of the resected specimens, he was diagnosed with adenocarcinoma in the anorectal fistula. CT and MRI revealed that the tumor had invaded into the internal obturator muscle. Therefore, preoperative chemoradiotherapy and chemotherapy were given for locally advanced cancer. Subsequent to tumor shrinkage, we performed an abdominoperineal resection. Histopathologically, no cancer cells were detected on the surgical margin, and the effect of the preoperative therapy was judged to be Grade 1b. There has been no indication of recurrence of cancer after 5 years.
- [Neoadjuvant Chemoradiotherapy for Locally Advanced Carcinoma Associated with Anal Fistula]. [Journal Article]
- GTGan To Kagaku Ryoho 2017; 44(12):1437-1439
- The patient was a 59-year-old man. He was admitted to our hospital because of increasing anal pain with induration of the perianal region. There were large secondary orifices with mucous discharge on...
The patient was a 59-year-old man. He was admitted to our hospital because of increasing anal pain with induration of the perianal region. There were large secondary orifices with mucous discharge on the left side of the perineal resion and buttock. We diagnosed adenocarcinoma on analysis of a biopsy specimen from induration of the perianal region. Pelvic CT and MRI showed that the tumor spreaded within the pelvis, with invasion of the prostate and sacrum. We performed neoadjuvant chemoradiotherapy preoperatively. After chemoradiotherapy, the tumor reduced in size greatly. We performed abdominoperineal resection and massive resection of skin of the perianal region. The defect of the pelvic floor and perianal skin was repaired using skin flap. The surgical margin was tumor free. Neoadjuvant chemoradiotherapy was considered effective for locally advanced carcinoma associated with anal fistula.
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- Anterior Sagittal Anorectoplasty with External Sphincter Preservation for the Treatment of Recto-vestibular Fistula: A New Approach. [Journal Article]
- JIJ Indian Assoc Pediatr Surg 2018 Jan-Mar; 23(1):4-9
- CONCLUSIONS: Our modification offers optimal correction, with minimal sphincteric damage, without additional complexity or difficulties. Scoring system is simple, practical, and truly reflects early functional and parent satisfaction after surgery.