Garg P, Kaur B, Yagnik VD, Dawka S. Including video and novel parameter-height of penetration of external anal sphincter-in magnetic resonance imaging reporting of anal fistula. World J Gastrointest Surg 2022; 14(4): 271-275 [PMID: 35664366 DOI: 10.4240/wjgs.v14.i4.271]
Corresponding Author of This Article
Pankaj Garg, MS, Associate Professor, Department of Colorectal Surgery, Garg Fistula Research Institute, 1043/15, Panchkula 134113, Haryana, India. drgargpankaj@gmail.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Diagnostic and Therapeutic Norms
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. Apr 27, 2022; 14(4): 271-275 Published online Apr 27, 2022. doi: 10.4240/wjgs.v14.i4.271
Including video and novel parameter-height of penetration of external anal sphincter-in magnetic resonance imaging reporting of anal fistula
Pankaj Garg, Baljit Kaur, Vipul D Yagnik, Sushil Dawka
Pankaj Garg, Department of Colorectal Surgery, Garg Fistula Research Institute, Panchkula 134113, Haryana, India
Pankaj Garg, Department of Colorectal Surgery, Indus International Hospital, Mohali 140507, Punjab, India
Baljit Kaur, Department of Radiology, SSRD Magnetic Resonance Imaging Institute, Chandigarh 160011, Chandigarh, India
Vipul D Yagnik, Department of Surgical Gastroenterology, Nishtha Surgical Hospital and Research Center, Patan 384265, Gujarat, India
Sushil Dawka, Department of Surgery, SSR Medical College, Belle Rive 744101, Belle Rive, Mauritius
Author contributions: Garg P conceived and designed the study, collected, and analyzed the data, revised the data, finally approved and submitted the manuscript (Guarantor of the review); Kaur B and Yagnik VD collected, and analyzed the data, revised the data, finally approved and submitted the manuscript; Dawka S critically analyzed the data, reviewed and edited the manuscript, finally approved and submitted the manuscript
Conflict-of-interest statement: None for all the authors.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Pankaj Garg, MS, Associate Professor, Department of Colorectal Surgery, Garg Fistula Research Institute, 1043/15, Panchkula 134113, Haryana, India. drgargpankaj@gmail.com
Received: November 17, 2021 Peer-review started: November 17, 2021 First decision: December 27, 2021 Revised: December 28, 2021 Accepted: April 4, 2022 Article in press: April 4, 2022 Published online: April 27, 2022 Processing time: 157 Days and 20.8 Hours
Abstract
The main purpose of a radiologist’s expertise in evaluation of anal fistula magnetic resonance imaging (MRI) is to benefit patients by decreasing the incontinence rate and increasing the healing rate. Any loss of vital information during the transfer of this data from the radiologist to the operating surgeon is unwarranted and is best prevented. In this regard, two methods are suggested. First, a short video to be attached with the standardized written report highlighting the vital parameters of the fistula. This would ensure minimum loss of information when it is conveyed from the radiologist to the operating surgeon. Second, inclusion of a new parameter, the amount of external sphincter involvement by the anal fistula. This parameter is usually not included in the MRI report. This can be evaluated as the height of penetration of the external anal sphincter (HOPE) by the fistula. The external anal sphincter plays a pivotal role in maintaining continence. This parameter (HOPE) is distinct from the ‘height of internal opening’ and assumes immense importance as its knowledge is paramount to prevent damage to the external anal sphincter by the surgeon during surgery.
Core Tip: There is loss of vital information when a fistula-in-ano magnetic resonance imaging (MRI) report from the radiologist is interpreted by the operating surgeon. To prevent this loss, a novel method is suggested: sending a small video highlighting vital fistula parameters along with the written MRI report. Also, another vital parameter is the amount of external sphincter involvement by the fistula. This parameter is not included in the MRI report and can be evaluated from the height of penetration of the external anal sphincter (HOPE) by the fistula. This parameter (HOPE) is distinct from the ‘height of internal opening’ and would help prevent damage to the external anal sphincter during surgery.
