ArticleAnnals of coloproctology2024
The management of complex fistula in ano by transanal opening of the intersphincteric space (TROPIS): short-term results.
Article in Annals of coloproctology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 15 citations in OpenAlex.
- Clinical efficacy and failure-related factors of the loose-seton procedure combined with transanal opening of the intersphincteric space technique (LoSet-TROPlS) in the treatment of complex anal fistulas.Techniques in coloproctology · 2026Article
- Pathophysiological mechanisms and clinical management of type 2 diabetes mellitus complicated with anal fistula.Frontiers in surgery · 2026Review
- Systematic review and meta-analysis of Transanal Opening of Intersphincteric Space (TROPIS) versus conventional treatments for anal fistula.Surgery open science · 2025Review
- Transanal Opening of the Intersphincteric Space (TROPIS) Is Effective in Managing High Complex as It Is Based on Garg Cardinal Principles.Digestive diseases and sciences · 2025Article
- Botulinum injection technique to reduce spasms in refractory anal fissures and after anal fistula or hemorrhoid surgery.Annals of coloproctology · 2024Article
- Structured magnetic resonance imaging and endoanal ultrasound anal fistulas reporting template (SMART): An interdisciplinary Delphi consensus.World journal of gastrointestinal surgery · 2024Article
- Efficacy and safety of transanal opening of intersphincteric space in the treatment of high complex anal fistula: A meta‑analysis.Experimental and therapeutic medicine · 2024Article
- Rectovaginal Fistulas Not Involving the Rectovaginal Septum Should Be Treated Like Anal Fistulas: A New Concept and Proposal for a Reclassification of Rectovaginal Fistulas.Clinical and experimental gastroenterology · 2024Article
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeMany methods have been used to treat complex fistulas, but no single technique has been considered standard. Damage to the sphincter may sometimes be unavoidable, and incontinence may be an important cause of morbidity. This study aimed to validate the results of transanal opening of the intersphincteric space (TROPIS), as a technique that avoids damaging the anal sphincter, in patients with complex fistula in ano.
methodsA prospective study was conducted among 35 consecutive patients with complex fistula in ano. After a preoperative magnetic resonance fistulogram, TROPIS was performed in all patients. The St. Mark's incontinence score was assessed preoperatively and postoperatively at 3 months.
resultsThe tracts were intersphincteric in 16 patients, transsphincteric in 10, extrasphincteric in 2, and horseshoe in 3. Four patients had recurrent tracts (3 transsphincteric and 1 intersphincteric). A defined follow-up schedule was used. Curettage was done if postoperative pus drainage from the wound was noted. The fistula healed in 29 patients (82.89%) following TROPIS. The remaining 6 patients received curettage, with healing in 3 (overall healing rate, 91.4%). Patients who received curettage were followed for 3 months, and the outcome was labeled as healed or failed. The mean preoperative incontinence score was 0. One patient developed incontinence to gas postoperatively in week 2, but there was no significant change in the scores at 3 months postoperatively. The mean postoperative incontinence score was 0.02.
conclusionTROPIS is an effective method for the treatment of complex fistula in ano, with minimal risk for incontinence.
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