Authors: R L Prosst A K Joos
Publish Date: 2016/09/26
Volume: 20, Issue: 11, Pages: 753-758
Abstract
In patients with anorectal fistulas minimally invasive surgery with the OTSC® Proctology system was performed according to a standardized technique the fistula tract was debrided using a special fistula brush and the clip was applied on the internal fistula opening In some of the patients postoperative pain was evaluated using a visual analog scale After 6 months the postoperative clinical course and the fistula healing were assessedA total of 100 OTSC® Proctology procedures were performed in 96 patients with 55 transsphincteric 38 suprasphincteric 2 extrasphincteric and 5 rectovaginal fistulas In all but 11 fistulas 8 Crohn’s disease 3 ulcerative colitis the fistulas were of cryptoglandular origin The median operation time was 32 min range 17–66 min There were no major intraoperative technical problems All patients found the postoperative pain to be tolerable with standard pain medication The shortterm results of 99 clip applications were analyzed the healing rate for firstline fistula therapy was 79 whereas in recurrent fistulas the success rate was 26 OTSC® Proctology was successful in 45 of fistulas associated with inflammatory bowel disease and in 20 of rectovaginal fistulasOTSC® Proctology provides convincing results as firstline treatment for complex cryptoglandular fistulas It is a safe effective minimally invasive and sphinctersparing procedure with postoperative pain comparable to other types of fistula surgery
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