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Tan KK, Koh DC, Tsang CB. Managing Deep Postanal Space Sepsis via an Intersphincteric Approach: Our Early Experience. Ann Coloproctol. 2013;29(2):55-9doi: 10.3393/ac.2013.29.2.55.
Tan, K. K., Koh, D. C., & Tsang, C. B. (2013). Managing Deep Postanal Space Sepsis via an Intersphincteric Approach: Our Early Experience. Annals of coloproctology, 29(2), 55-9. https://doi.org/10.3393/ac.2013.29.2.55
Tan, Ker-Kan, et al. "Managing Deep Postanal Space Sepsis via an Intersphincteric Approach: Our Early Experience." Annals of coloproctology vol. 29,2 (2013): 55-9. doi: https://doi.org/10.3393/ac.2013.29.2.55
Tan KK, Koh DC, Tsang CB. Managing Deep Postanal Space Sepsis via an Intersphincteric Approach: Our Early Experience. Ann Coloproctol. 2013 Apr;29(2):55-9. doi: 10.3393/ac.2013.29.2.55. Epub 2013 Apr 30. PMID: 23700571; PMCID: PMC3659243.
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Ann Coloproctol. 2013 Apr;29(2):55-9. doi: 10.3393/ac.2013.29.2.55. Epub 2013 Apr 30.

Managing Deep Postanal Space Sepsis via an Intersphincteric Approach: Our Early Experience.

Annals of coloproctology

Ker-Kan Tan, Dean C Koh, Charles B Tsang

Affiliations

  1. Division of Colorectal Surgery, University Surgical Cluster, National University Health System, Singapore.

PMID: 23700571 PMCID: PMC3659243 DOI: 10.3393/ac.2013.29.2.55

Abstract

PURPOSE: Managing deep postanal (DPA) sepsis often involves multiple procedures over a long time. An intersphincteric approach allows adequate drainage to be performed while tackling the primary pathology at the same sitting. The aim of our study was to evaluate this novel technique in managing DPA sepsis.

METHODS: A retrospective review of all patients who underwent this intersphincteric technique in managing DPA sepsis from February 2008 to October 2010 was performed. All surgeries were performed by the same surgeon.

RESULTS: Seventeen patients with a median age of 43 years (range, 32 to 71 years) and comprised of 94.1% (n = 16) males formed the study group. In all patients, an internal opening in the posterior midline with a tract leading to the deep postanal space was identified. This intersphincteric approach operation was adopted as the primary procedure in 12 patients (70.6%) and was successful in 11 (91.7%). In the only failure, the sepsis recurred, and a successful advancement flap procedure was eventually performed. Five other patients (29.4%) underwent this same procedure as a secondary procedure after an initial drainage operation. Only one was successful. In the remaining four patients, one had a recurrent abscess that required drainage while the other three patients had a tract between the internal opening and the intersphincteric incision. They subsequently underwent a drainage procedure with seton insertion and advancement flap procedures.

CONCLUSION: Managing DPA space sepsis via an intersphincteric approach is successful in 70.6% of patients. This single-staged technique allows for effective drainage of the sepsis and removal of the primary pathology in the intersphincteric space.

Keywords: Abscess; Anal gland; Fistula; Treatment outcome

References

  1. Dis Colon Rectum. 1986 Dec;29(12):793-7 - PubMed
  2. BMC Surg. 2003 Nov 26;3:10 - PubMed
  3. Dis Colon Rectum. 2008 Jun;51(6):852-7 - PubMed
  4. J Med Assoc Thai. 2007 Mar;90(3):581-6 - PubMed
  5. Dis Colon Rectum. 1965 Sep-Oct;8(5):364-8 - PubMed
  6. Dis Colon Rectum. 1976 Sep;19(6):507-15 - PubMed
  7. Dis Colon Rectum. 1975 Nov-Dec;18(8):642-5 - PubMed
  8. Am J Surg. 1994 May;167(5):513-5 - PubMed
  9. Br J Surg. 1998 Feb;85(2):243-5 - PubMed
  10. Tech Coloproctol. 2009 Dec;13(4):301-6 - PubMed
  11. Dis Colon Rectum. 2011 Dec;54(12):1537-41 - PubMed
  12. Surg Innov. 2006 Mar;13(1):17-21 - PubMed
  13. Tech Coloproctol. 2009 Sep;13(3):237-40 - PubMed

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