Modified Hanley Procedure for Management of Complex Posterior Horseshoe Anal Fistula | ||
| The Egyptian Journal of Hospital Medicine | ||
| Article 53, Volume 94, Issue 1, January 2024, Pages 358-362 PDF (477.87 K) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/ejhm.2024.337732 | ||
| Abstract | ||
| Background:An anorectal fistula is a connection that is not normal among the epithelialized surface of the anal canal and most commonly the skin of the perianal region or the perineum. Surgery is the mainstay therapy aiming to drain local infection, to eliminate the fistulous tract and to avoid its recurrence while maintaining the function of the sphincter. Aim: This study aimedto evaluate thetreated patients with horseshoe fistula of cryptoglandular origin utilizing a modified Hanley method involving a hybrid cutting one-stage approach. Methods:This prospective trial was done on twenty cases with chronic horseshoe fistula. All patients were subjected to preoperative PR examination to check for sphincter tone, preoperativeMRI to demonstrate the extent of fistulaand the deep post-analspace affection. Results: Regarding type of fistula, 3 (15%) persons had high trans-sphincteric fistula & 17 (85%) patients had low trans-sphincteric fistula. Seven (35%) patients had external opening from the anal verge within three centimetres and 13 (65%) patients had external opening from the anal verge beyond 3 cm. Out of the total number of individuals, three individuals (15%) had an internal opening located at the dentate line, while the remaining 17 individuals (85%) had an internal opening situated above the dentate line. Four (20%) patients had recurrence. Complete healing was achieved in all cases at 12 weeks post-operative period. Conclusions: The modified Hanley operation is effective and conservative surgical procedure that eliminates the disadvantage of keeping the seton for a long period and preserve the sphincter function. | ||
| Keywords | ||
| Modified Hanleyprocedure; Complex posteriorhorseshoe anal fistula; Anorectal abscess | ||
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