{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,1,15]],"date-time":"2025-01-15T05:21:31Z","timestamp":1736918491207,"version":"3.33.0"},"reference-count":11,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[1991,5,1]],"date-time":"1991-05-01T00:00:00Z","timestamp":673056000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1991,5,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Twenty-four (3\u00b76 per cent) patients with problematical anal fistulae out of 671 with anal fistulae were analysed to assess the reasons for their recurrences and ultimate outcome. Thirteen patients (group A) had recurrent fistulae despite two definitive attempts at surgery at this hospital (median number of previous procedures before referral to this hospital was two, range 0\u20137; median number of definitive procedures at this hospital was three, range 3\u20134). In five of these patients, the reason for recurrence was missed primary (four cases) or secondary tracks (one case) at earlier operations. Five patients required multiple operations related to the use of setons. Eleven other patients (group B) required colostomy construction, eight because of severe perianal sepsis, two because of complex fistulae, and one for postrectal dermoid. Fistula healing occurred ultimately in all patients in group A afer a median of 14 months (range 4\u201338 months). In group B, fistula healing occurred in eight patients after a median of 7.5 months (range 2\u201355 months) after colostomy construction. Only one patient has had a proctectomy, and five still have their colostomy. Of the other 18 patients, continence is normal in 14, there is mucus leakage in two, flatus incontinence in one and faecal incontinence in one. In conclusion, persistent attempts to resolve anal fistulae in difficult cases are frequently successful in the long term and result in good continence.<\/jats:p>","DOI":"10.1002\/bjs.1800780508","type":"journal-article","created":{"date-parts":[[2007,3,3]],"date-time":"2007-03-03T15:57:54Z","timestamp":1172937474000},"page":"539-541","source":"Crossref","is-referenced-by-count":70,"title":["Insights gained from the management of problematical anal fistulae at St. Mark's Hospital, 1984\u201388"],"prefix":"10.1093","volume":"78","author":[{"given":"Seow","family":"Choen","sequence":"first","affiliation":[{"name":"St. Mark's Hospital , City Road, London EC1V 2PS,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R K S","family":"Phillips","sequence":"additional","affiliation":[{"name":"St. Mark's Hospital , City Road, London EC1V 2PS,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[1991,5,1]]},"reference":[{"key":"2024092809405109100_bib1","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1007\/BF01647694","article-title":"Symposium. Fistula-in-ano","volume":"2","author":"Abcarian","year":"1987","journal-title":"Int J Colored Dis"},{"key":"2024092809405109100_bib2","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1007\/BF01648418","article-title":"Fistula-in-ano is usually easy to manage surgically","volume":"1","author":"Shouler","year":"1986","journal-title":"Int J Colored Dis"},{"key":"2024092809405109100_bib3","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1007\/BF01644991","article-title":"Can the external anal sphincter be preserved in the treatment of transphincteric fistula-in-ano","volume":"4","author":"Thomson","year":"1989","journal-title":"Int J Colored Dis"},{"key":"2024092809405109100_bib4","doi-asserted-by":"crossref","first-page":"793","DOI":"10.1007\/BF02555347","article-title":"Management of anorectal horseshoe abscess and fistula","volume":"29","author":"Held","year":"1986","journal-title":"Dis Colon Rectum"},{"key":"2024092809405109100_bib5","doi-asserted-by":"crossref","first-page":"454","DOI":"10.1007\/BF02561583","article-title":"Treatment of trans-sphincteric anal fistulas by the seton technique","volume":"29","author":"Christensen","year":"1986","journal-title":"Dis Colon Rectum"},{"key":"2024092809405109100_bib6","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1002\/bjs.1800630102","article-title":"A classification of fistula-in-ano","volume":"63","author":"Parks","year":"1976","journal-title":"Br J Surg"},{"key":"2024092809405109100_bib7","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1007\/BF02552656","article-title":"Fistulography for fistula-in-ano","volume":"28","author":"Kuijpers","year":"1985","journal-title":"Dis Colon Rectum"},{"key":"2024092809405109100_bib8","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1111\/j.1445-2197.1986.tb02347.x","article-title":"Use of hydrogen peroxide to identify internal opening of anal fistula and perianal abscess","volume":"56","author":"Glen","year":"1986","journal-title":"Aust NZ J Surg"},{"key":"2024092809405109100_bib9","doi-asserted-by":"crossref","first-page":"752","DOI":"10.1002\/bjs.1800760737","article-title":"Anal endosonography in the evaluation of perianal sepsis and fistula-in-ano","volume":"76","author":"Law","year":"1989","journal-title":"Br J Surg"},{"key":"2024092809405109100_bib10","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1002\/bjs.1800780418","article-title":"A comparison between anal endosonography and digital examination in the evaluation of anal fistulae","volume":"78","author":"","year":"1991","journal-title":"Br J Surg"},{"key":"2024092809405109100_bib11","first-page":"71","article-title":"Management of fistula-in-ano","volume":"8","author":"Phillips","year":"1989","journal-title":"Curr Med Lit Gastroenterol"}],"container-title":["Journal of British Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fbjs.1800780508","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/academic.oup.com\/bjs\/article-pdf\/78\/5\/539\/59394497\/bjs1800780508.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/bjs\/article-pdf\/78\/5\/539\/59394497\/bjs1800780508.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,14]],"date-time":"2025-01-14T15:09:56Z","timestamp":1736867396000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/bjs\/article\/78\/5\/539\/6174830"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1991,5,1]]},"references-count":11,"journal-issue":{"issue":"5","published-online":{"date-parts":[[1991,5,1]]},"published-print":{"date-parts":[[1991,5,1]]}},"URL":"https:\/\/doi.org\/10.1002\/bjs.1800780508","relation":{},"ISSN":["0007-1323","1365-2168"],"issn-type":[{"type":"print","value":"0007-1323"},{"type":"electronic","value":"1365-2168"}],"subject":[],"published-other":{"date-parts":[[1991,5]]},"published":{"date-parts":[[1991,5,1]]}}}