title: Update on anal fistulae: surgical perspectives for the gastroenterologist.
abstract: Anal fistulae are common and debilitating; they are characterized by severe pain and discharge. They arise following infection near the anal canal, or as a primary event from an abscess in the abdomen, fistulating into the vagina or perianal skin. The term 'cryptoglandular' is given to abscesses arising from the anal glands.For many years, the treatment of choice was to lay open the fistula; however, this risks causing incontinence with potentially devastating consequences. Alternative surgical treatments include setons, fibrin glue, collagen plugs and flaps to cover the internal fistula opening. These have achieved varying degrees of success, as will be discussed. The present review also discusses anal fistulae in light of much recently published literature. Currently, anal fistulae remain challenging and require specialist expertise; however, new treatment options are on the horizon.
authors.affiliation: Depart of Digestive Diseases, Royal Sussex County Hospital, Brighton, United Kingdom. tabry121@yahoo.com
authors.forename: Helena
authors.initials: H
authors.lastname: Tabry
authors.forename: Paul A
authors.initials: PA
authors.lastname: Farrands
mesh_terms: D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D003424:Crohn Disease / Q000175:diagnosis; D015718:Fibrin Tissue Adhesive / Q000627:therapeutic use; D005762:Gastroenterology; D017497:Hidradenitis Suppurativa / Q000175:diagnosis; D006801:Humans; D000069285:Infliximab; D012003:Rectal Fistula / Q000145:classification / Q000601:surgery*; D013524:Surgical Flaps; D014014:Tissue Adhesives / Q000008:administration & dosage; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors
chemical_list: D000911:Antibodies, Monoclonal; D015718:Fibrin Tissue Adhesive; D014014:Tissue Adhesives; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab