Avaliação das características anatômicas da fístula anal através da ultrassonografia anorretal tridimensional e correlação com a teoria de Goodsall

• Ano de defesa: 2017
• Autor(a) principal: Oliveira, Maura Tarciany Coutinho Cajazeiras
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Palavras-chave em Português: Fístula; Ultrassonografia
• Link de acesso: http://www.repositorio.ufc.br/handle/riufc/27783

Evaluation of the anatomical characteristics of the anal fistula through three-dimensional anorectal ultrasonography and correlation with Goodsall’s theory. Maura Tarciany Coutinho Cajazeiras de Oliveira. A Stricto Sensu Master of Medical-Surgical Sciences, Faculty of Medicine of the Federal University of Ceará (Master's thesis). August, 2017. Advisor: Profa. Dr. Sthela Maria Murad Regadas. The Anal fistula is one of the great challenges for coloproctologists, whose surgical treatment is often associated with continence disorders and high recurrence rates. Thus, extensive knowledge of the anatomy of anal fistulas may help avoid these results. The objective of this study was to evaluate the anatomical characteristics of the anal fistulas of the transsphincteric type, using a three-dimensional ultrasound (US-3D) analysis in both sexes. In addition, correlating ultrasonographic findings with a Goodsall’s Rule and with transoperative findings, which is ideal for comparisons between the sexes. The patients were submitted to US-3D to identify the type of fistulous tract (FT) (straight or curved) and the location of the internal orifice (IO) and external orifice (EO) on the anterior (AHC) and posterior (PHC) hemicircumference of the anal canal, being distributed in 3 groups. GI: EO and IO located in the AHC; GII: EO and IO located in the PHC; E GIII: EO and IO located in opposite hemicircumferences. A total of 151 patients with a mean age of 40.3 years were included. GI (n = 74; 49%) included 41 (55%) men (straight FT: n = 33/44%, curved FT: n = 8/10%) and 33 (45%) women (straight FT: n = 15/20%; curved FT: n = 18/25%). GII (n = 68; 45%) included 50 (74%) males (straight FT: n = 39/57%, curved FT: n = 11/16%) and 18 (26%) females (straight FT: n = 14/21%, curved FT: n = 04/6%). GIII (n = 9; 6%) included 5 males and 4 females, all with curved FT. A concordance between US-3D and surgical findings was 99% for main FT, 98% for secondary and 98% for IO. It was concluded that, in the fistulas located in the AHC, the ultrasonographic findings have a correlation with a Goodsall’s Rule in the male sex, but not in the female sex, the distribution of the two types of path is similar. For fistulas in PHC, no correlation is observed in either sexes. A correlation between ultrasonographic and transoperative findings is high.