Management of cryptoglandular fistula-in-ano among gastrointestinal surgeons in the Netherlands

• DOI: 10.1007/s10151-021-02446-3
• Publication Date: 2021-04-15T16:04:44Z
• Authors: L. Dekker; D. D. E. Zimmerman; R. M. Smeenk; R. Schouten; I. J. M. Han-Geurts
• Keywords: Fistulotomy; Colorectal Surgery

Abstract Background Management of cryptoglandular fistula-in-ano (FIA) can be challenging. Despite Dutch and international guidelines determining optimal therapy is still quite difficult. The aim this study was to report current practices in the management FIA among gastrointestinal surgeons Netherlands. Methods residents who are treating regularly were sent a survey invitation by email. available online from September 19 December 1 2019. questionnaire consisted 28 questions concerning diagnostic surgical techniques treatment intersphincteric transsphincteric FIA. Results In total, 147 (43%) responded completed survey. Magnetic resonance imaging preferred modality (97%) followed endo-anal ultrasound (12%). case high FIA, 86% used non-cutting seton. Most respondents removed seton between 6 weeks 3 months ( n = 84, 58%). Fistulotomy procedure preference low (86%) (92%). Mucosal advancement flap (MAF) ligation fistula tract (LIFT), with 78% 46%, respectively, procedures that applied most often 67% performed MAF 33% fistulotomy. Thirty-three percent all stated they habitually closed internal opening, half them Z-plasty. For debridement method curettage (78%). Conclusions use various Novel promising should investigated adequately sufficient large trials increase consensus. A core outcome measurement prospective database would help comparing results. Until then, adjusted individual patient, governed characteristics patient choice.