Annali italiani di chirurgia · 2006
[Transrectal ultrasonography by rotating feeler in the perianal fistulae/abscesses surgery. Anatomo-functional description].
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Cafaro Danilo, Onofrio Luciano
Аннотация
INTRODUCTION: Anal fistula represents a big topically subject above all as regards the complex correlated surgical implications. The transectal ultrasonography (TUS) is the first help for a careful, cheep, poorly invasive diagnosis.
MATERIALS AND METHODS: From September 2002 to December 2003 we submitted TUS 53 patient with clinical diagnosis of perianal fistula abscesses and 27 patients, already subordinates to surgical intervention for perianal fistulae/abscesses, which only presented perianal pain without clear signs of perianal pathology (48 males and 15 females).
RESULTS: TUS diagnosis and surgical confirmation of abscess and/or anal fistulae in all the patients; in the 27 patients, in whom at clinician exam was not clear an abscess, it was diagnosed in 21 patients (6 positive-false).
DISCUSSION: The obtained data show the validity of this methodical diagnostics and its importance for a correct surgical management. The 7.2% of discovered positive-false (surgical response: scary tissue), they are to charge to the objective technical dfficulty with discriminating scary outcomes; in confirmation of that the datum that in all these cases the patients had already been submitted to previous ano-rectal surgery.
CONCLUSIONS: Surgery of the anal abscesses and fistulas, for effective being, must stay in balance between aggressiveness and safeguards surgery. Surgery, to be correct, cannot leave out of consideration TUS: a valid tool in the Pre-operatory diagnosis, but also in the Post-operatory phase to highlight possible recidivisms.
MATERIALS AND METHODS: From September 2002 to December 2003 we submitted TUS 53 patient with clinical diagnosis of perianal fistula abscesses and 27 patients, already subordinates to surgical intervention for perianal fistulae/abscesses, which only presented perianal pain without clear signs of perianal pathology (48 males and 15 females).
RESULTS: TUS diagnosis and surgical confirmation of abscess and/or anal fistulae in all the patients; in the 27 patients, in whom at clinician exam was not clear an abscess, it was diagnosed in 21 patients (6 positive-false).
DISCUSSION: The obtained data show the validity of this methodical diagnostics and its importance for a correct surgical management. The 7.2% of discovered positive-false (surgical response: scary tissue), they are to charge to the objective technical dfficulty with discriminating scary outcomes; in confirmation of that the datum that in all these cases the patients had already been submitted to previous ano-rectal surgery.
CONCLUSIONS: Surgery of the anal abscesses and fistulas, for effective being, must stay in balance between aggressiveness and safeguards surgery. Surgery, to be correct, cannot leave out of consideration TUS: a valid tool in the Pre-operatory diagnosis, but also in the Post-operatory phase to highlight possible recidivisms.