Comparison of preoperative examination findings and endoanal ultrasonography results with operation findings in perianal fistula disease

eray, ismail cem; TÜMER, HALUK

doi:10.17826/cumj.1218980

Comparison of preoperative examination findings and endoanal ultrasonography results with operation findings in perianal fistula disease

Haluk TÜMER, (Seyhan Devlet Üniversitesi, Adana, Türkiye)

İsmail Cem ERAY (Çukurova Üniversitesi, Tıp Fakültesi, Genel Cerrahi Anabilim Dalı, Adana, Türkiye)

Cukurova Medical Journal

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Yıl: 2023 Cilt: 48 Sayı: 2 Sayfa Aralığı: 330 - 335 Metin Dili: İngilizce DOI: 10.17826/cumj.1218980 İndeks Tarihi: 28-09-2023

Comparison of preoperative examination findings and endoanal ultrasonography results with operation findings in perianal fistula disease

Öz:

Purpose: The aim of the current study was to compare the preoperative examination findings, endoanal ultrasonography results, and operative findings in patients diagnosed with perianal fistula. Materials and Methods: A prospective study was conducted between 2021 and 2022 on patients who underwent surgical treatment for perianal fistula. The patients were recorded and classified according to the Park classification by the surgeon performing the operation. Subsequently, a surgeon with 10 years of endoanal ultrasonography experience reclassified the patients and recorded the findings (Ultrasonographic Evaluation - USE). The surgery was performed by a different surgeon who was blind to the USE results and the final diagnosis was recorded (Evaluation Under Anesthesia - EAU). The preoperative examination findings, endoanal ultrasonography findings, and operative findings were compared postoperatively. Results: The study included 60 patients, with 52 being male and 8 being female, and a mean age of 44.2 ± 12.6 years. The patients were classified as low transsphincteric (TSF), intersphincteric (ISF), and high TSF at ratios of 40%, 33.3%, and 26.7%, respectively (24, 20, and 16 patients, respectively). Endoanal ultrasonography found that 30%, 35%, and 21.7% of patients had low TSF, ISF, and high TSF, respectively (18, 21, and 13 patients, respectively), while postoperatively, 45%, 33%, and 21.7% of patients were classified as low TSF, ISF, and high TSF, respectively (27, 20, and 13 patients, respectively). The ISF rate in preoperative examination findings was significantly higher than in postoperative diagnoses, with intermediate coherence between the two diagnoses (κ: 0.462). The rates of low and high TSF were found to be significantly higher in ultrasonography findings than in postoperative diagnoses, with high coherence between the two (κ: 0.701). Conclusion: Endoanal ultrasonography is important for mapping, especially for transsphincteric fistulas, in the surgical treatment of perianal fistulas.

Anahtar Kelime: Endoanal sonography perianal fistula preoperative diagnosis

Perianal fistül hastalığında preoperatif muayene bulguları ile endoanal ultrasonografi bulgularının ameliyat bulguları ile kıyaslanması

Öz:

Amaç: Bu çalışmada, perianal fistül tanısı alan hastaların preoperatif muayene bulguları ile endoanal ultrasonografi bulgularının ameliyat bulguları ile kıyaslanması amaçlandı Gereç ve Yöntem: Çalışma 2021-2022 yılları arasında perianal fistül nedeniyle cerrahi olarak tedavi edilen hastalarda prospektif olarak yapıldı. Anal fistül nedeniyle ameliyat edilen hastalara operasyonu yapacak cerrah tarafından poliklinik şartlarında muayene edilerek Park sınıflamasına göre sınıflandırılarak kayıt altına alındı. Daha sonra tüm hastalar, 10 yılllık endoanal ultrasonografi deneyimi olan bir cerrah tarafından sınıflandırılarak kayıt altına alınmıştır (Ultrasonographic evaluation (USE)). Ameliyatı ise FM yapan cerrah tarafından EUS sonucundan habersiz olarak gerçekleştirmiş ve nihai tanıyı kayıt altına almıştır (EAU evaluation under anesthesia). Operasyondan sonra fizik muayene bulguları ve endoanal ultrsound bulguları operasyon bulguları ile karşılaştırıldı. Bulgular: Hastaların 52’si erkek 8’i kadındı. Yaş ortalaması 44,2±12,6 idi. Klinik değerlendirme ile hastaların %40 alçak TSF(transfinkterik), %33,3’ü İSF (intersfinkterik) ve %26,7’si yüksek TSF olarak sınıflandırıldı (sırasıyla 24, 20 ve 16 hasta). Endosonografik olarak hastaların %30’u alçak TSF, %35’i İSF, %21,7’si yüksek TSF olarak sınıflandırıldı (sırasıyla 18, 21 ve 13 hasta). Perioperatif değerlendirilen hastaların %45’i alçak TSF, %33’ü İSF ve %21,7’si yüksek TSF olarak değerlendirildi (sırasıyla 27, 20 ve 13 hasta). Fiziki muayene bulgularının İSF oranı ile postop tanı bulgularında anlamlı derece yüksek bulundu. Fiziki muayene tanı bulguları ile postop tanı bulguları arasındaki uyumluluğun ise orta düzeyde bir uyumluluk gösterdiği tespit edildi (κ: 0,462) Ultrason muayene bulgularında Alçak ve Yüksek TSF oranlarının postop tanı bulgularında anlamlı derece yüksek olduğu tespit edildi. Ultrason muayene tanı bulguları ile postop tanı bulguları arasındaki uyumluluğun ise yüksek düzeyde bir uyumluluk gösterdiği belirlendi (κ: 0,701) Sonuç: Perianal fistül cerrahi tedavisinde endoanal ultrasoun özellikle transfinkterik fistüllerin haritalandırmasında önemli olduğu saptanmıştır

Anahtar Kelime: Endoanal sonograph perianal fistula preoperative diagnosis

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

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APA	TÜMER H, eray i (2023). Comparison of preoperative examination findings and endoanal ultrasonography results with operation findings in perianal fistula disease. , 330 - 335. 10.17826/cumj.1218980
Chicago	TÜMER HALUK,eray ismail cem Comparison of preoperative examination findings and endoanal ultrasonography results with operation findings in perianal fistula disease. (2023): 330 - 335. 10.17826/cumj.1218980
MLA	TÜMER HALUK,eray ismail cem Comparison of preoperative examination findings and endoanal ultrasonography results with operation findings in perianal fistula disease. , 2023, ss.330 - 335. 10.17826/cumj.1218980
AMA	TÜMER H,eray i Comparison of preoperative examination findings and endoanal ultrasonography results with operation findings in perianal fistula disease. . 2023; 330 - 335. 10.17826/cumj.1218980
Vancouver	TÜMER H,eray i Comparison of preoperative examination findings and endoanal ultrasonography results with operation findings in perianal fistula disease. . 2023; 330 - 335. 10.17826/cumj.1218980
IEEE	TÜMER H,eray i "Comparison of preoperative examination findings and endoanal ultrasonography results with operation findings in perianal fistula disease." , ss.330 - 335, 2023. 10.17826/cumj.1218980
ISNAD	TÜMER, HALUK - eray, ismail cem. "Comparison of preoperative examination findings and endoanal ultrasonography results with operation findings in perianal fistula disease". (2023), 330-335. https://doi.org/10.17826/cumj.1218980

APA	TÜMER H, eray i (2023). Comparison of preoperative examination findings and endoanal ultrasonography results with operation findings in perianal fistula disease. Cukurova Medical Journal, 48(2), 330 - 335. 10.17826/cumj.1218980
Chicago	TÜMER HALUK,eray ismail cem Comparison of preoperative examination findings and endoanal ultrasonography results with operation findings in perianal fistula disease. Cukurova Medical Journal 48, no.2 (2023): 330 - 335. 10.17826/cumj.1218980
MLA	TÜMER HALUK,eray ismail cem Comparison of preoperative examination findings and endoanal ultrasonography results with operation findings in perianal fistula disease. Cukurova Medical Journal, vol.48, no.2, 2023, ss.330 - 335. 10.17826/cumj.1218980
AMA	TÜMER H,eray i Comparison of preoperative examination findings and endoanal ultrasonography results with operation findings in perianal fistula disease. Cukurova Medical Journal. 2023; 48(2): 330 - 335. 10.17826/cumj.1218980
Vancouver	TÜMER H,eray i Comparison of preoperative examination findings and endoanal ultrasonography results with operation findings in perianal fistula disease. Cukurova Medical Journal. 2023; 48(2): 330 - 335. 10.17826/cumj.1218980
IEEE	TÜMER H,eray i "Comparison of preoperative examination findings and endoanal ultrasonography results with operation findings in perianal fistula disease." Cukurova Medical Journal, 48, ss.330 - 335, 2023. 10.17826/cumj.1218980
ISNAD	TÜMER, HALUK - eray, ismail cem. "Comparison of preoperative examination findings and endoanal ultrasonography results with operation findings in perianal fistula disease". Cukurova Medical Journal 48/2 (2023), 330-335. https://doi.org/10.17826/cumj.1218980