Factores de riesgo y análisis de la recurrencia en el tratamiento quirúrgico de la fístula anal



Título del documento: Factores de riesgo y análisis de la recurrencia en el tratamiento quirúrgico de la fístula anal
Revista: Revista mexicana de coloproctología
Base de datos: PERIÓDICA
Número de sistema: 000362898
ISSN: 1405-3756
Autores: 1
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Instituciones: 1Universidad Nacional de Tucumán, Facultad de Medicina, San Miguel de Tucumán, Tucumán. Argentina
Año:
Periodo: Dic
Volumen: 17
Paginación: 10-16
País: México
Idioma: Español
Tipo de documento: Estadística o encuesta
Enfoque: Descriptivo
Resumen en español claro. Los resultados funcionales fueron buenos aunque se registró ensuciamiento en la mitad de los casos. Los varones jóvenes con fístulas complejas (transes finterianas altas), de localización posterior, con más de un factor de riesgo y con una cirugía previa realizada por un cirujano no especialista, fueron los factores asociados a la presencia de recidiva de la fístula anal
Resumen en inglés Recurrence and incontinence are the two more important aspects about surgi- cal treatment of fi stula-in-ano. Its treatment is probably one of the most challenging situa- tions in anal surgery. Objective: To analyze risk factors related to recurrence in anal fi stula treated by any surgical procedure. Setting: Colorectal Unit, Sanatorio Modelo, Tucuman. Design: Retrospective consecutive series; period 2000-2009. Population: 15 recurrences after surgery. Methods: 170 consecutive cases in an elective basis. Variables: Age, sex, MCI, smoking, diabetes, location, surgical technique, type, number and time of recurrence, immediate and late morbility and incontinence. This series was matched with global one. Excel Vista prospective bases was used and statistical SPSS10.0 software considering signi fi cance when p < 0.05. Results: 15 recurrences (8.8%). Age: 49 years (35-63), 14/1 (M/F), all were criptoglandular. According to type, 2 were simple and 13, complex. Follow up was possible in 92%. Immediate soiling was 50% and late disturbes in continence were reported in 4 cases. Surgical techniques used were: fi stulotomy, seton, mucosal advance. Conclusions: Incidence of recurrence was similar to literature and more frequent in complex fi stula. Functional outcome was good, although half of patients reported soiling. There was not only one clear risk factor associated to recurrence. Young male with complex fi stula, particularly high transphinteric, located posteriorly, with more than one risk factor and with previous surgery performed by non-specialist are related with high incidence of recurrence
Disciplinas: Medicina
Palabras clave: Cirugía,
Gastroenterología,
Fístulas,
Ano,
Fistulotomía,
Recidiva,
Factores de riesgo,
Técnicas quirúrgicas
Keyword: Medicine,
Gastroenterology,
Surgery,
Fistulae,
Anus,
Fistulotomy,
Recurrence,
Risk factors,
Surgical techniques
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