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The bared external anal sphincter (BEAS), a new technique for high horseshoe anal fistula: a hospital-based cohort study

The aim of this study was to introduce a new technique, the bared external anal sphincter technique, and to evaluate its effectiveness and safety for primary or recurrent high horseshoe anal fistula (HHAF). We used data from a tertiary referral hospital’s prospective database of a hospital-based coh...

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Bibliographic Details
Published in:Scientific reports 2023-04, Vol.13 (1), p.5871-5871, Article 5871
Main Authors: Zhu, Jingyi, Du, Peixin, Wang, Zhenyi, Zheng, De, Wang, Qingming, Mei, Zubing
Format: Article
Language:English
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Summary:The aim of this study was to introduce a new technique, the bared external anal sphincter technique, and to evaluate its effectiveness and safety for primary or recurrent high horseshoe anal fistula (HHAF). We used data from a tertiary referral hospital’s prospective database of a hospital-based cohort. All the patients underwent the bared external anal sphincter procedure. The main outcomes were short‐term clinical outcomes including the 6-month cure rate, Visual Analog Scale pain score (VAS-PS) and Cleveland Clinic Florida incontinence score (CCF-IS). The secondary outcomes included the Quality of Life in Patients with Anal Fistula Questionnaire score (QoLAF-QS), Bristol stool chart and postoperative complications. A total of 48 HHAF patients (39 males) with a mean age of 34.2 years (SD 9.04; range, 21–54) were analyzed in this retrospective study. At the 6-month follow-up, the average VAS-PS and CCF-IS were 0.81 (SD 2.28; range, 0–10) and 1.29 (SD 2.87; range, 0–13), respectively. QoLAF-QS showed that the bared external anal sphincter procedure had no impact over their quality of life in 45 patients (93.75%), limited impact in 2 patients (4.16%), and moderate impact in one patient (2.08%). The Bristol stool scale showed that all patients had normal stool characteristics. The 6-month cure rate was 93.75%. Three patients (6.25%) experienced recurrent symptoms but recovered after surgical management. Urinary retention occurred in 1 case (2.78%). No other postoperative complications were reported. No patient had anal incontinence. The bared external anal sphincter procedure is a safe, effective and sphincter-sparing approach for patients with primary or recurrent HHAF in terms of short‐term results.
ISSN:2045-2322
2045-2322
DOI:10.1038/s41598-023-32698-y