Perianale fistels: veranderde inzichten met betreklking tot classificatie en diagnostiek, en een nieuwe behandelstrategie

Translated title of the contribution: Perianal fistulas: developments in the classification and diagnostic techniques, and a new treatment strategy

P J van Koperen, K Horsthuis, W A Bemelman, J Stoker, J F M Slors

Research output: Contribution to journalReview articleAcademicpeer-review

Abstract

The aim of surgical treatment of perianal fistulas is to treat the patient's symptoms, with low recurrence rates and risk of incontinence. In recent years there have been developments regarding the classification and diagnosis ofperianal fistulas. MRI is the most appropriate diagnostic tool. In the hands of an experienced operator anal endosonography is a suitable, less expensive and readily-available alternative. As a result of developments in fistula surgery it is now more practical to classify perianal fistulas as low or high fistulas, as this has implications for the further treatment. Low perianal fistulas are defined as fistulas of which the fistula tract is located in the lower third of the external anal sphincter. High fistulas are fistulas in which the fistula tract runs through the upper two-thirds of the external sphincter muscle. Low perianal fistulas can be treated safely by fistulotomy. At present, rectal advancement is the gold standard for the surgical treatment of high transsphincteric perianal fistulas. The anal fistula plug might be an alternative for the treatment of high transsphincteric perianal fistulas.

Translated title of the contributionPerianal fistulas: developments in the classification and diagnostic techniques, and a new treatment strategy
Original languageDutch
Pages (from-to)2774-80
Number of pages7
JournalNederlands Tijdschrift voor Geneeskunde
Volume152
Issue number51-52
Publication statusPublished - 20 Dec 2008

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