Copyright
©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. May 6, 2020; 8(9): 1586-1591
Published online May 6, 2020. doi: 10.12998/wjcc.v8.i9.1586
Published online May 6, 2020. doi: 10.12998/wjcc.v8.i9.1586
Recurrent anal fistulas: When, why, and how to manage?
Sameh Hany Emile, Colorectal Surgery Unit, General Surgery Department, Mansoura University Hospitals, Mansoura University, Mansoura 35516, Egypt
Author contributions: Emile SH designed and wrote the manuscript.
Conflict-of-interest statement: All authors declare no conflicts-of-interest related to this article.
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: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Sameh Hany Emile, MBChB, MD, MSc, Lecturer, Surgeon, General Surgery Department, Mansoura University, Faculty of Medicine, Dakahlia Governorate, Mansoura 35516, Egypt. sameh200@hotmail.com
Received: February 28, 2020
Peer-review started: February 28, 2020
First decision: April 8, 2020
Revised: April 12, 2020
Accepted: April 22, 2020
Article in press: April 22, 2020
Published online: May 6, 2020
Processing time: 61 Days and 23.2 Hours
Peer-review started: February 28, 2020
First decision: April 8, 2020
Revised: April 12, 2020
Accepted: April 22, 2020
Article in press: April 22, 2020
Published online: May 6, 2020
Processing time: 61 Days and 23.2 Hours
Core Tip
Core tip: Recurrent anal fistulas represent a unique challenge to general and colorectal surgeons. They are usually associated with high risk of re-recurrence and fecal incontinence. The risk factors for recurrence of anal fistula after surgery include preoperative, intraoperative, and postoperative factors. Thorough assessment of recurrent anal fistulas is crucial before planning treatment. Endoanal ultrasonography and magnetic resonance imaging are the most widely used modalities for the assessment of recurrent anal fistulas. Treatment of recurrent anal fistula should address the cause of recurrence, extirpate the entire fistula tract, ensure adequate drainage of sepsis and at the same time preserve the anal sphincters and continence.