Conclusion
Etiology, pathology and surgical management, herein discussed, are based on information gained from a study of the records of over 500 patients, nearly all of whom were private, and in whom a careful follow-up study was available.
The modern approach herein outlined reverses the deeply ingrained teaching of the management of large wounds with wide skin and tissue sacrifice required to assure the wound will heal from within outward. Maximum conservatism in the sacrifice of skin is stressed throughout the presentation. Cure is accomplished by the linear or curvilinear incision utilized to provide exposure. In the cryptoglandular intermuscular group of fistulous abscesses, most of the surgical procedure is performed within the anorectum and healing proceeds from without inward.
Deep infections of the ischiorectal fossae are managed effectively by a conservative plastic procedure.
Thirty per cent of the total cases were selected for ambulatory surgery, the operations being performed with the patients under the influence of local infiltration anesthesia.
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References
Bremer, J. L.: Textbook of Histology. Ed. 4, Philadelphia, The Blakiston Company, 1930, p. 289.
Bremner, C. G.: Anorectal disease in the South African Bantu. South African J. Surg.2: 147, 1964.
Courtney, H.: The posterior subsphincteric space: Its relation to posterior horseshoe fistula. Surg., Gynec. & Obst.89: 222, 1949.
Eisenhammer, S.: The internal anal sphincter: Its surgical importance. South African M. J.27: 266, 1953.
Eisenhammer, S.: Advance of anorectal surgery with special reference to ambulatory treatment. South African M. J.28: 264, 1954.
Eisenhammer, S.: The internal anal sphincter and the anorectal abscess. Surg., Gynec. & Obst.103: 501, 1956.
Eisenhammer, S.: A new approach to the anorectal fistulous abscess based on the high intermuscular lesion. Surg., Gynec. & Obst.106: 595, 1958.
Eisenhammer, S.: The anoscrotal and anovulval fistulous abscess. Surg., Gynec. & Obst.113: 519, 1961.
Eisenhammer, S.: Long-tract anteroposterior intermuscular fistula. Dis. Colon & Rectum.7: 438, 1964.
Goligher, J. C.: Results of internal sphincterotomy for anal fissure. Brit. M. J.1: 1500, 1962.
Gorsch, R. V.: Proctologic Anatomy. Baltimore, The Williams & Wilkins Company, pp. 190; 195.
Graham-Stewart, C. W.: The etiology and treatment of fissure-in-ano. Surg., Gynec. & Obst.115: 511, 1962.
Herrmann, G. and L. Defosses: Sur la muquese de la region cloacle du rectum. Acad. Sc.90: 1301, 1880.
Hill, M. R., E. H. Shryock, and F. G. ReBell: Role of the anal glands in the pathogenesis of anorectal disease. J.A.M.A.121: 742, 1943.
Lockhart-Mummery, J. P.: Discussion of fistula-in-ano. Proc. Roy. Soc. Med.22: 1331, 1929.
Morgan, C. N. and H. R. Thompson: Surgical anatomy of the anal canal with special reference to the surgical importance of the internal sphincter and conjoint longitudinal muscle. Ann. Roy. Coll. Surgeons, England.19: 88, 1956.
Parks, A. G.: Pathogenesis and treatment of fistula-in-ano. Brit. M. J.1: 462, 1961.
Parks, A. G.: Etiology and surgical treatment of fistula-in-ano. Dis. Colon & Rectum.6: 17, 1963.
Shropshear, G.: The surgical anatomy of the anorectal sphincter mechanism and its clinical significance. J. Internat. Coll. Surgeons.33: 267, 1960.
Thompson, H.: The orthodox conception of fistula-in-ano and its treatment. Proc. Roy. Soc. Med.55: 754, 1962.
Tucker, C. C. and C. A. Hellwig: Histopathology of the anal crypts. Surg., Gynec. & Obst.58: 145, 1934.
Watts, J. McK., R. C. Bennett, and J. C. Goligher: Stretching of anal sphincters in treatment of fissure-in-ano. Brit. M. J.1: 342, 1964.
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Eisenhammer, S. The anorectal fistulous abscess and fistula. Dis Colon Rectum 9, 91–106 (1966). https://doi.org/10.1007/BF02617307
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DOI: https://doi.org/10.1007/BF02617307