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| 1 | Lessons learned from an audit of 1250 anal fistula patients operated at a single center:A retrospective review显示文摘BACKGROUND A complex anal fistula is a challenging disease to manage.AIM To review the experience and insights gained in treating a large cohort of patients at an exclusive fistula center.METHODS Anal fistulas operated on by a single surgeon over 14 years were analyzed.Preoperative magnetic resonance imaging was done in all patients.Four procedures were performed:fistulotomy;two novel sphincter-saving procedures,proximal superficial cauterization of the internal opening and regular emptying and curettage of fistula tracts(PERFACT)and transanal opening of intersphincteric space(TROPIS),and anal fistula plug.PERFACT was initiated before TROPIS.As per the institutional GFRI algorithm,fistulotomy was done in simple fistulas,and TROPIS was done in complex fistulas.Fistulas with associated abscesses were treated by definitive surgery.Incontinence was evaluated objectively by Vaizey incontinence scores.RESULTS A total of 1351 anal fistula operations were performed in 1250 patients.The overall fistula healing rate was 19.4%in anal fistula plug(n=56),50.3%in PERFACT(n=175),86%in TROPIS(n=408),and 98.6%in fistulotomy(n=611)patients.Continence did not change significantly after surgery in any group.As per the new algorithm,1019 patients were operated with either the fistulotomy or TROPIS procedure.The overall success rate was 93.5%in those patients.In a subgroup analysis,the overall healing rate in supralevator,horseshoe,and fistulas with an associated abscess was 82%,85.8%,and 90.6%,respectively.The 90.6%healing rate in fistulas with an associated abscess was comparable to that of fistulas with no abscess(94.5%,P=0.057,not significant).CONCLUSION Fistulotomy had a high 98.6%healing rate in simple fistulas without deterioration of continence if the patient selection was done judiciously.The sphincter-sparing procedure,TROPIS,was safe,with a satisfactory 86%healing rate for complex fistulas.This is the largest anal fistula series to date. | Pankaj Garg Baljit Kaur Ankita Goyal Vipul D Yagnik Sushil Dawka Geetha R Menon | 2021 | World Journal of Gastrointestinal Surgery2021，13，4： | 8 |
| 2 | Diagnosis of anorectal tuberculosis by polymerase chain reaction,GeneXpert and histopathology in 1336 samples in 776 anal fistula patients显示文摘BACKGROUND The association of tuberculosis(TB)with anal fistulas can make its treatment quite difficult.The main challenge is timely detection of TB in anal fistulas and its proper management.There is little data available on diagnosis and management of TB in anal fistulas.AIM To detect TB in fistula-in-ano patients were analyzed in different methods utilized.METHODS A retrospective analysis of different methods,polymerase chain-reaction(PCR),GeneXpert and histopathology(HPE),utilized to detect tuberculosis in fistula-inano patients,treated between 2014-2020,was performed.The sampling was done for tissue(fistula tract lining)and pus(when available).The detection rate of various tests to detect TB and prevalence rate of TB in simple vs complex fistulae were studied.RESULTS In 1336 samples(776 patients)tested,TB was detected in 133 samples(122 patients).TB was detected in 52/703(7.4%)samples tested by PCR-tissue,in 77/331(23.2%)samples tested by PCR-pus,3/197(1.5%)samples tested with HPE-tissue and 1/105(0.9%)samples tested by GeneXpert.To detect TB,PCRtissue was significantly better than HPE-tissue(52/703 vs 3/197 respectively)(P=0.0012,significant,Fisher’s exact test)and PCR-pus was significantly better than PCR-tissue(77/331 vs 52/703 respectively)(P<0.00001,significant,Fisher’s exact test).TB fistulas were more complex than non-tuberculous fistulas[78/113(69%)vs 278/727(44.3%)respectively](P<0.00001,significant,Fisher’s exact test)but the overall healing rate was similar in tuberculous and non-tuberculous fistula groups[90/102(88.2%)vs 518/556(93.2%)respectively](P=0.10,not significant,Fisher’s exact test).CONCLUSION This is the largest study of anorectal TB to be published.The detection of TB by polymerase chain-reaction was significantly higher than by histopathology and GeneXpert.Amongst polymerase chain-reaction,pus had a higher detection rate than tissue.TB fistulas were more complex than non-tuberculous fistulas but aggressive diagnosis and meticulous treatment led to comparable overall success rates in both groups. | Pankaj Garg Ankita Goyal Vipul D Yagnik Sushil Dawka Geetha R Menon | 2021 | World Journal of Gastrointestinal Surgery2021，13，4： | 3 |
| 3 | Effect of atrial fibrillation on atrial refractoriness in humans 显示文摘 | Daoud EG Bogun F Goyal R | 1996 | Circulation1996，94，7： | 1 |
| 4 | Direct synthesis of diphenyl carbonate by oxidative carbonylation of phenol using Pd-Cu based redox catalyst system显示文摘 | Goyal M Nagahata R Sugiyama J | 1999 | J Mol Catal A:Chem1999，137，123： | 1 |
| 5 | Adrenal Suppression and Failure to Thrive after Steroid Injections for Periocular Heman- gioma 显示文摘 | Goyal R Patrick Watts Carol | 2004 | Ophthalmology2004，111，2： | 1 |
| 6 | Recurrent and residual juvenile angiofibromas显示文摘 | TYAGI I SYAL R GOYAL A | 2007 | J Laryngol Otol2007，121，： | 1 |
| 7 | Rheumatologie and autoimmune manifestations of primary immunodeficiency disorders 显示文摘 | Goyal R Bulua AC Nikolov NP | 2009 | Curr Opin Rheumato12009，21，1： | 1 |
| 8 | Functional anatomy and physiology of the upper esophageal sphincter显示文摘 | Sivarao D V Goyal R K | 2000 | Am J Med2000，108，4： | 1 |
| 9 | Economic and health consequences of selling a kidney in India显示文摘 | GOYAL M MEHETA R L SCHEIDERMAN L J | 2002 | JAMA2002，288，3： | 1 |
| 10 | Changing focus of unexplained esophageal chest pain显示文摘 | | 1996 | Ann Intern Med1996，124，11： | 1 |
| 11 | Analysis of junctional ectopy during radiofrequency ablation of the slow pathway in patients with atrioventricular nodal reentrant tachycardia 显示文摘 | JENTZER J H GOYAL R WILLIAMSON B D | 1994 | Circulation1994，90，： | 1 |
| 12 | Renal tubulointerstitial injury from ureteral obstruction in the neonatal rat is attenuated by IGF-Ⅰ显示文摘 | CHEVALIER R L GOYAL S KIM A | 2000 | Kidney Int2000，57，3： | 1 |
| 13 | Failure of indicator bacteria to reflect the occurrence of enteroviruses in marine waters 显示文摘 | GERBA C P GOYAL S M LABELLE R L | 1979 | Am J Public Health1979，69，： | 1 |
| 14 | Entoptic narration during phacoemulsification by an ophthalmologist显示文摘 | Singh R Goyal D Vasavada AR | 2002 | J Cataract Refract Surg2002，28，： | 1 |
| 15 | Application of response surface methodology for maximizing dextransucrase production from Leuconostoc mesenteroides NRRL B-640 in a bioreactor显示文摘 | PURAMA R K GOYAL A | 2008 | Applied biochemistry and biotechnology2008，151，23： | 1 |
| 16 | Influence of Carbon-Oxygen Surface Groups on the Adsorption of Phenol by Activated Carbons显示文摘 | Bansal R C Aggarwal D Goyal M | 2002 | Indian Journal of Chemical Technology2002，9，4： | 1 |
| 17 | Effects of doping concentration and annealing temperature on properties of highly-oriented Al-doped ZnO films显示文摘 | Goyal D J Agashe C M Marathe B R l | 1992 | Journal of Materials Science Letters1992，，11： | 1 |
| 18 | Redox chemistry of guanine and 8-oxyguanine and a comparison of the peroxidase-catalyzed and electrochemical oxidation of 8-oxyguanine 显示文摘 | Goyal R N Dryhurst G | 1982 | J Electroanal Chem1982，135，： | 1 |
| 19 | Bone- sparing effect of soy protein in ovarian hormone - deficient rats is related to its isoflavone content显示文摘 | Birnbaum R Goyal NV | 1998 | Am J Clin Nutr1998，68，6： | 1 |
| 20 | The Dnmtl DNA - (cytosine -C5) -methyhransferase methylates DNA processively with high preference for hemimethylated target sites 显示文摘 | Hermann A Goyal R Jehsch A | 2004 | J Biol Chem2004，279，48： | 1 |
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