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Background <p>Anal fistula is a common condition affecting millions of people worldwide. Diagnosis and treatment require accurate imaging. Magnetic resonance imaging (MRI) is widely used for assessing anal fistula, but its limitations have led to the development of other imaging modalities. Intra-operative ultrasound has been proposed as a complementary technique to enhance the accuracy of surgical planning and treatment outcomes.</p> Objective <p>To evaluate the clinical effects of intra-operative ultrasound on preserving continence and reducing recurrence in anal fistula.</p> Methods <p>This prospective comparative study included 60 patients with primary or recurrent anal fistula who underwent surgery, divided into two groups: (Group A) 30 patients with preoperative MRI only and (Group B) 30 patients with additional intra-operative ultrasound.</p> Results <p>The study showed that the mean operative time was significantly lower in (Group A) (35.27 ± 9.41 min) compared to (Group B) (66.9 ± 11.91 min). The Wexner incontinence score was also significantly higher in (Group A) (7.77) compared to (Group B) (3.10). Postoperative follow-up outcomes showed that there were significant differences between the two groups in terms of fistula recurrence, incontinence, MRI unhealed tract and complete healing. However, the mean time to complete healing was significantly longer in (Group A) (7.47 weeks) compared to (Group B) (5.97 weeks). Recurrence time was significantly shorter in (Group A) (4.17 months) compared to (Group B) (7 months). The study found that the use of intra-operative ultrasound improved the accuracy of surgical planning and treatment outcomes, resulting in a higher rate of successful healing and a lower rate of recurrence.</p> Conclusion <p>Results of this study suggest that intra-operative ultrasound is a valuable adjunctive technique that can improve accuracy of surgical planning and treatment outcomes in patients with anal fistula and its use may reduce the risk of recurrence and improve continence outcomes. Further studies are needed to confirm these findings and to explore potential benefits of using intra-operative ultrasound in other surgical specialties.</p>

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The add value of intra-operative ultrasound to preoperative MRI in preserving continence and decreasing incidence of recurrence in anal fistula

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年7月9日

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  • Rimon Rizk,
  • Faten Ali,
  • Ahmed Abd El Basset

摘要

Background

Anal fistula is a common condition affecting millions of people worldwide. Diagnosis and treatment require accurate imaging. Magnetic resonance imaging (MRI) is widely used for assessing anal fistula, but its limitations have led to the development of other imaging modalities. Intra-operative ultrasound has been proposed as a complementary technique to enhance the accuracy of surgical planning and treatment outcomes.

Objective

To evaluate the clinical effects of intra-operative ultrasound on preserving continence and reducing recurrence in anal fistula.

Methods

This prospective comparative study included 60 patients with primary or recurrent anal fistula who underwent surgery, divided into two groups: (Group A) 30 patients with preoperative MRI only and (Group B) 30 patients with additional intra-operative ultrasound.

Results

The study showed that the mean operative time was significantly lower in (Group A) (35.27 ± 9.41 min) compared to (Group B) (66.9 ± 11.91 min). The Wexner incontinence score was also significantly higher in (Group A) (7.77) compared to (Group B) (3.10). Postoperative follow-up outcomes showed that there were significant differences between the two groups in terms of fistula recurrence, incontinence, MRI unhealed tract and complete healing. However, the mean time to complete healing was significantly longer in (Group A) (7.47 weeks) compared to (Group B) (5.97 weeks). Recurrence time was significantly shorter in (Group A) (4.17 months) compared to (Group B) (7 months). The study found that the use of intra-operative ultrasound improved the accuracy of surgical planning and treatment outcomes, resulting in a higher rate of successful healing and a lower rate of recurrence.

Conclusion

Results of this study suggest that intra-operative ultrasound is a valuable adjunctive technique that can improve accuracy of surgical planning and treatment outcomes in patients with anal fistula and its use may reduce the risk of recurrence and improve continence outcomes. Further studies are needed to confirm these findings and to explore potential benefits of using intra-operative ultrasound in other surgical specialties.