FOCUS ON – Consensus Statement SICCR – Perianal abscess and anal fistula (Commented by Antonio Amato)

Evaluation and management of perianal abscess and anal fistula: a consensus statement developed by the Italian Society of Colorectal Surgery (SICCR)

Amato A, Bottini C, De Nardi P, Giamundo P, Lauretta A, Realis Luc A, Tegon G, Nicholls RJ.
Tech Coloproctol. 2015 Oct;19(10):595-606. doi: 10.1007/s10151-015-1365-7. Epub 2015 Sep 16.

Mixed blessing of colorectal surgeon, the treatment of anal fistula shows a wide spectrum of diagnostic and surgical technical problems. From simple fistula which requires a basic diagnostic work up and a relatively simple surgical procedure to complex fistula which often needs high-tech diagnostic tools and technically demanding operations. Recurrences and iatrogenic fecal incontinence are the main complications that can jeopardize the surgical outcome, requiring a challenging balance between to do too and to do too little. In the last decades a growing number of “sphincter saving” innovative procedures have been described, A critical review of the pertinent literature is reported showing that sometimes, despite the application of high technology, the promising results of the initial papers were not confirmed by subsequent studies and long-term follow-up found a declining success. (Antonio Amato)