File(s) under embargo

1909

days

7

hours

until file(s) become available

Pathogenesis and persistence of cryptoglandular anal fistula: a systematic review

journal contribution
posted on 26.06.2018 by J Sugrue, J Nordenstam, H Abcarian, A Bartholomew, JL Schwartz, A Mellgren, PJ Tozer
Anal fistulas continue to be a problem for patients and surgeons alike despite scientific advances. While patient and anatomical characteristics are important to surgeons who are evaluating patients with anal fistulas, their development and persistence likely involves a multifaceted interaction of histological, microbiological, and molecular factors. Histological studies have shown that anal fistulas are variably epithelialized and are surrounded by dense collagen tissue with pockets of inflammatory cells. Yet, it remains unknown if or how histological differences impact fistula healing. The presence of a perianal abscess that contains gut flora commonly leads to the development of anal fistula. This implies a microbiological component, but bacteria are infrequently found in chronic fistulas. Recent work has shown an increased expression of proinflammatory cytokines and epithelial to mesenchymal cell transition in both cryptoglandular and Crohn's perianal fistulas. This suggests that molecular mechanisms may also play a role in both fistula development and persistence. The aim of this study was to examine the histological, microbiological, molecular, and host factors that contribute to the development and persistence of anal fistulas.

History

Publisher Statement

Post print version of article may differ from published version. The final publication is available at springerlink.com; DOI:10.1007/s10151-017-1645-5

Publisher

Springer Verlag

Language

en_US

issn

1123-6337

Issue date

01/06/2017

Exports

Categories

Exports