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Posterior Approach for Debridement of the Psoas Abscess
Published on: March 2, 2020
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Anal Abscess and Fistula.
Nipa D Gandhi1, Eziwoma O Alibo2, Jordan H Gipe2
1Department of Surgery, Colon and Rectal Surgery, Icahn School of Medicine at Mount Sinai, 425 West 59th Street, New York, NY 10019, USA.
The Surgical Clinics of North America
|November 15, 2025
Summary
Anorectal abscesses and fistulas are common surgical issues, often from cryptoglandular infections. Treatment involves prompt drainage for abscesses and fistula tract anatomy-based surgery to preserve continence.
Area of Science:
- Colorectal Surgery
- Gastroenterology
- Surgical Infections
Background:
- Anorectal abscesses and fistulas are prevalent surgical conditions.
- Most cases are idiopathic, stemming from cryptoglandular infections.
- Accurate diagnosis requires clinical evaluation and imaging to assess sphincter involvement.
Purpose of the Study:
- To outline the diagnostic and management strategies for anorectal abscesses and fistulas.
- To review current surgical treatments for anal fistulas, emphasizing continence preservation.
- To discuss emerging therapies for these conditions.
Main Methods:
- Review of diagnostic approaches including history, physical examination, and imaging.
- Analysis of surgical management principles for anorectal abscesses and fistulas.
- Evaluation of various surgical techniques such as fistulotomy, seton placement, advancement flap, Ligation of Intersphincteric Fistula Tract (LIFT), and Video-Assisted Anal Fistula Treatment (VAAFT).
Main Results:
- Abscess treatment necessitates immediate surgical drainage.
- Fistula management prioritizes healing while maintaining anal continence.
- Surgical outcomes are contingent upon the fistula tract's anatomy.
- Established surgical options include fistulotomy, seton placement, advancement flap, LIFT, and VAAFT.
Conclusions:
- Prompt drainage is key for anorectal abscesses.
- Surgical treatment for anal fistulas must balance healing with continence.
- Fistula tract anatomy dictates the optimal surgical approach.
- Mesenchymal stem cell injections represent a promising but unproven future therapy.
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