{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T05:01:18Z","timestamp":1771477278144,"version":"3.50.1"},"reference-count":18,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2020,2,17]],"date-time":"2020-02-17T00:00:00Z","timestamp":1581897600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2020,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Accurate preoperative identification of perianal fistula tracts and internal openings can facilitate the choice of surgical procedure and may lead to improved healing rates. Our aim was to explore the effectiveness of three\u2010dimensional endoanal ultrasound (3D\u2010EAUS) in determining the type of perianal fistula and planning operative management.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>This was a cohort longitudinal study. Patients with perianal fistulas from January 2017 to January 2018 who underwent 3D\u2010EAUS and subsequent surgery were included. Intra\u2010operative findings were considered as standard for comparison with clinical examination and 3D\u2010EAUS findings. The primary outcome measure was to evaluate the concordance between 3D\u2010EAUS and intra\u2010operative findings and the secondary outcome measure was healing rates.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Sixty\u2010eight patients with a mean age of 43.1\u00a0\u00b1\u00a014.1\u00a0years were included. Twenty\u2010eight patients had inter\u2010sphincteric (41.2%) and 40 (14 high and 26 low) trans\u2010sphincteric fistulas (58.8%). 3D\u2010EAUS, clinical examination and intra\u2010operative exploration could predict the location of internal openings in 62\/68 (91.2%), 48\/68 (70.5%) and 56\/68 (82.4%) patients, respectively. Hydrogen peroxide (H\u2082O\u2082)\u2010enhanced 3D\u2010EAUS accurately predicted the location of internal openings when compared with 3D\u2010EAUS without <jats:styled-content style=\"fixed-case\">H\u2082O\u2082<\/jats:styled-content> (concordance <jats:italic>K<\/jats:italic>\u00a0=\u00a00.963, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.05). High concordance rates were seen between intra\u2010operative and 3D\u2010EAUS findings on the type of perianal fistula. No significant difference was seen between the suggested surgical treatment based on 3D\u2010EAUS and the eventual surgical treatment (<jats:italic>P<\/jats:italic>\u00a0&gt;\u00a00.05). Study limitations were the small sample size and lack of randomization.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>3D\u2010EAUS may be considered as a first\u2010line investigation for patients with perianal fistulas because of high concordance with intra\u2010operative assessment and facilitation of surgical planning.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.14993","type":"journal-article","created":{"date-parts":[[2020,1,28]],"date-time":"2020-01-28T22:12:15Z","timestamp":1580249535000},"page":"931-938","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Using preoperative three\u2010dimensional endoanal ultrasound to determine operative procedure in patients with perianal fistulas"],"prefix":"10.1111","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4339-417X","authenticated-orcid":false,"given":"S.","family":"Mantoo","sequence":"first","affiliation":[{"name":"Department of Surgery Khoo Teck Puat Hospital Singapore City Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P.","family":"Mandovra","sequence":"additional","affiliation":[{"name":"Department of Surgery Khoo Teck Puat Hospital Singapore City Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4916-2142","authenticated-orcid":false,"given":"S.","family":"Goh","sequence":"additional","affiliation":[{"name":"Department of Surgery Khoo Teck Puat Hospital Singapore City 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