dc.contributor.author |
Deen, K.I. |
en_US |
dc.contributor.author |
Gunawardena, P.A.H.A. |
en_US |
dc.date.accessioned |
2014-10-29T09:19:14Z |
|
dc.date.available |
2014-10-29T09:19:14Z |
|
dc.date.issued |
2001 |
en_US |
dc.identifier.citation |
ANZ Journal of Surgery; 71(8): pp.472-74 |
en_US |
dc.identifier.issn |
1445-1433 (Print) |
en_US |
dc.identifier.issn |
1445-2197 (Electronic) |
en_US |
dc.identifier.uri |
http://repository.kln.ac.lk/handle/123456789/1481 |
|
dc.description.abstract |
BACKGROUND: Identification of the internal opening is an essential step in the management of fistula-in-ano. The predictive accuracy of Goodsall's rule is compared with instillation of hydrogen peroxide for fistulas-in-ano. METHODS: Thirty-five patients (32 male, three female; median age 42 years; range: 6 months-70 years) were studied. Hydrogen peroxide solution was injected into the external opening of the fistula track and effervescence was observed at the internal opening within the anal canal. A fistula track was either excised or incised. Setons were placed within high fistulas. RESULTS: There were 24 simple fistulas, compared to 11 complex fistulas (horseshoe, n = 4; abscess, n = 4). Eighteen external openings were anterior and 17 were posterior. Thirty-four of 35 (97%) internal openings were identified. Only 20 internal openings were in accordance with Goodsall's rule (positive predictive value: 59%). Predictive accuracy was greater for anterior external openings (13 of 18 (72%)) versus posterior external openings (six of 17 (41%); P = 0.016). For recurrent fistulas, seven of 17 fistula tracks had an internal opening in accordance with Goodsall's rule, resulting in a positive predictive value of 41%. (Positive predictive value: anterior 67% vs posterior 12.5%; P = 0.0009.) CONCLUSION: The overall predictive accuracy of Goodsall's rule was poor chiefly because of poor predictive accuracy in posterior and recurrent fistulas. The use of Goodsall's rule alone in decision-making before surgical intervention is not recommended. |
|
dc.publisher |
Wiley-Blackwell Pub. Asia |
en_US |
dc.subject |
Diagnostic Techniques, Digestive System |
|
dc.subject |
Hydrogen Peroxide-administration and dosage |
|
dc.subject |
Hydrogen Peroxide-diagnostic use |
|
dc.subject |
Rectal Fistula-diagnosis |
|
dc.subject |
Rectal Fistula-surgery |
|
dc.title |
Comparison of hydrogen peroxide instillation with Goodsall's rule for fistula in-ano |
en_US |
dc.type |
Article |
en_US |
dc.identifier.department |
Surgery |
en_US |
dc.creator.corporateauthor |
Royal Australasian College of Surgeons |
en_US |