复发性肛瘘：何时、为何以及如何处理？
Recurrent anal fistulas: When, why, and how to manage?
作者信息
Emile Sameh Hany
机构信息
Colorectal Surgery Unit, General Surgery Department, Mansoura University Hospitals, Mansoura University, Mansoura 35516, Egypt.
出版信息
World J Clin Cases. 2020 May 6;8(9):1586-1591. doi: 10.12998/wjcc.v8.i9.1586.
Abstract
Anal fistula is a commonly encountered anal condition in the surgical practice. Despite being a benign condition, anal fistula remains to represent a surgical challenge, particularly the complex type of fistulas. One of the common complications of anal fistula surgery is the persistence or recurrence of the pathology, both defined as failure of surgery. Recurrent anal fistulas after previous surgery represent an even more challenging problem since they are usually associated with a higher risk of re-recurrence and continence disturbance. The present review aimed to shed light on various aspects of recurrent anal fistulas, including the different definitions of failure after surgery, risk factors of recurrence, problems associated with management of recurrent fistulas, and assessment and treatment of recurrent anal fistulas.
摘要
肛瘘是外科实践中常见的肛门疾病。尽管是良性疾病，但肛瘘仍然是一个手术挑战，尤其是复杂型肛瘘。肛瘘手术的常见并发症之一是病理状况持续存在或复发，这两种情况均被定义为手术失败。既往手术后复发的肛瘘是一个更具挑战性的问题，因为它们通常伴有更高的再次复发风险和大便失禁。本综述旨在阐明复发性肛瘘的各个方面，包括手术后失败的不同定义、复发的危险因素、与复发性肛瘘管理相关的问题以及复发性肛瘘的评估和治疗。
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2
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3
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IDCases. 2018 Mar 3;12:25-28. doi: 10.1016/j.idcr.2018.02.012. eCollection 2018.
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