TY - JOUR T1 - Perianal Fistüllerde Cerrahi Tedavi Protokolleri ve Malignite Riski: Tek Merkezli Retrospektif Bir Çalışma TT - Surgical Treatment Protocols and Risk of Malignancy in Perianal Fistulas: A Single-Center Retrospective Study AU - Tali, Ufuk AU - Balbaloglu, Hakan PY - 2025 DA - August Y2 - 2025 DO - 10.29058/mjwbs.1616550 JF - Medical Journal of Western Black Sea JO - Med J West Black Sea PB - Zonguldak Bulent Ecevit University WT - DergiPark SN - 2822-4302 SP - 187 EP - 192 VL - 9 IS - 2 LA - tr AB - Amaç: Çalışmanın amacı, perianal fistül hastalığında farklı tedavi seçeneklerinin sonuçlarını tek bir büyük hasta kohortunda araştırmaktır.Gereç ve Yöntemler: Çalışmaya 2020-2024 yılları arasında ameliyat edilen 176 ardışık hasta retrospektif olarak dahil edildi. Başvurusemptomları (akıntı, şişlik vb.), perianal fistül tipleri (basit, intersfinkterik, ekstrasfinkterik vb.) ve cerrahi tedaviler (seton, fistülotomi, lazervb.) belirlendiBulgular: Çalışmamızda dört hastada malign patoloji sonucu saptandı. Bu hastaların ortak özelliği ileri yaşta olmaları ve kronik akıntışikayeti ile sağlık merkezlerine başvurmamış olmalarıydı.Sonuç: Bu tür destekleyici görüntüleme ve tanısal işlemler, doğru tanı ve uygun tedavinin belirlenmesini kolaylaştırarak tedavi başarısınıartırabilir ve komplikasyon riskini azaltabilir. KW - Anal fistül KW - malignite KW - cerrahi N2 - Aim: The aim of the study was to investigate the outcomes of different treatment options for perianal fistula disease in a single large patientcohort.Material and Methods: The study retrospectively included 176 consecutive patients operated between 2020 and 2024. Symptoms atpresentation (discharge, swelling, etc.), perianal fistula types (simple, intersphincteric, extrasphincteric, etc.) and surgical treatments (seton,fistulotomy, laser, etc.) were determinedResults: In our study, malignant pathology results were found in four patients. The common feature of these patients was their advancedage and the fact that they had not applied to health centres with complaints of chronic discharge.Conclusion: Such supportive imaging and diagnostic procedures may improve treatment success and reduce the risk of complications byfacilitating accurate diagnosis and determination of appropriate treatment CR - 1. Bartelsman JF. Haemorrhoids, rectal prolapse, anal fissure, peri-anal fistulae and sexually transmitted diseases. Best Pract Res Clin Gastroenterol. 2009;23(4):575-92. https://doi. org/10.1016/j.bpg.2009.04.010 CR - 2. Göksoy E (editor). General Surgery, Volume 2, Nobel Medical Publishing, Ankara; 2021;1138-39. CR - 3. Geçim İ. Ethem, Demirkıran Arda, Principles of Surgery, Tarlan Ltd. Company. 2016;1229-30. CR - 4. Abcarian H. Anorectal infection: abscess-fistula. Clin Colon Rectal Surg. 2011;24(1):14-21. https://doi. org/10.1055/s-0031-1272819 CR - 5. Öz DK, Zorlu SNY, Eskalen Z, Ateş FSÖ, Akyol C, Erden A, Geçim İE. Goodsall’s Rule Revisited: An MRI-Based Assessment of its Accuracy in Perianal Fistulas. Turk J Colorectal Dis. 2025;35(2):41-7. https://doi:10.4274/tjcd.galenos. 2025.2025-1-2. CR - 6. Ong J, Jit-Fong L, Ming-Hian K, Boon-Swee O, Kok-Sun H, Eu KW. Perianal mucinous adenocarcinoma arising from chronic anorectal fistulae: a review from a single institution. Tech Coloproctol. 2007;11:34–8. https://doi.org/10.1007/s10151-007- 0322-5 CR - 7. Leal RF, Ayrizono MLS, Coy CSR, Fagundes JJ, Góes JR. Mucinous adenocarcinoma derived from chronic perianal fistulas: report of a case and review of the literature. Tech Coloproctol. 2007;11:155–7. https://doi.org/10.1007/s10151-007-0348-8 CR - 8. Yamaguchi T, Kagawa R, Takahashi H, Takeda R, Sakata S, Nishizaki D. Diagnostic implications of MR imaging for mucinous adenocarcinoma arising from fistula in ano. Tech Coloproctol. 2009;13:251–3. https://doi.org/10.1007/s10151-009- 0509-z CR - 9. Stellingwerf ME, van Praag EM, Tozer PJ, Bemelman WA, Buskens CJ. Systematic review and meta-analysis of endorectal advancement flap and ligation of the intersphincteric fistula tract for cryptoglandular and Crohn’s high perianal fistulas. BJS open. 2019;3(3);231–41. https://doi.org/10.1002/bjs5.50129 CR - 10. Enck P, Bielefeldt K, Rathmann W, Purrmann J, Tschöpe D, Erckenbrecht JF. Epidemiology of faecal incontinence in selected patient groups. Colorectal Dis. 1991;6:143–6. https://doi. org/10.1007/BF00341234 CR - 11. Theerapol A, So BY, Ngoi SS. Routine use of setons for the treatment of anal fistulae. Singapore Med J. 2002;43:305-307 CR - 12. Kronborg O. To lay open or excise a fistula-in-ano: a randomized trial. Br J Surg. 1985;72(12):970. doi: 10.1002/bjs.1800721211. PMID: 3910159. https://doi.org/10.1002/bjs.1800721211 CR - 13. Nagtegaal ID, Odze RD, Klimstra D, Paradis V, Rugge M, Schirmacher P, Washington KM, Carneiro F, Cree IA. WHO Classification of Tumours Editorial Board. The 2019 WHO classification of tumours of the digestive system. Histopathology. 2020;76(2):182-8. https://doi.org/10.1111/his.13975 CR - 14. Hama Y, Makita K, Yamana T, Dodanuki K. Mucinous adenocarcinoma arising from fistula in ano: MRI findings. AJR Am J Roentgenol. 2006;187(2):517-21. https://doi.org/10.2214/ AJR.05.0011 CR - 15. Rzepakowska A, Osuch-Wójcikiewicz E, Ochal-Choińska A, Bruzgielewicz A, Chęciński P, Nyckowska J, Szwedowicz P. Przetoki skórne jako powikłanie po laryngektomii całkowitej-- analiza materiału Kliniki Otolaryngologii WUM i przegląd piśmiennictwa [Pharyngocutaneous fistula as a complication after total laryngectomy--clinical study and literature review]. Otolaryngol Pol. 2011;65(5 Suppl):22-30. https://doi. org/10.1016/S0030-6657(11)70705-3 CR - 16. Osone K, Ogawa H, Katayama C, Shibasaki Y, Suga K, Komine C, Ozawa N, Okada T, Shiraishi T, Katoh R, Sakai M, Sano A, Yokobori T, Matsumura N, Sohda M, Shirabe K, Saeki H. Outcomes of surgical treatment in patients with anorectal fistula cancer. Surg Case Rep. 2021;7(1):32. https://doi.org/10.1186/ s40792-021-01118-6 CR - 17. Kodama M, Kobayashi D, Iihara K, Abe K, Sahara R, Sassa M, Yamana T, Furukawa S, Yao T, Uchida K, Tamura T, Negi M, Eishi Y. Adenocarcinoma within anorectal fistulae: different clinicopathological characteristics between Crohn’s disease-associated type and the usual type. Mod Pathol. 2019;32(2):314- 325 https://doi.org/10.1038/s41379-018-0105-8 CR - 18. Scharl M, Frei P, Frei SM, Biedermann L, Weber A, Rogler G. Epithelial-to-mesenchymal transition in a fistula-associated anal adenocarcinoma in a patient with long-standing Crohn’s disease. Eur J Gastroenterol Hepatol. 2014;26(1):114-8. https://doi.org/10.1097/MEG.0b013e32836371a2 UR - https://doi.org/10.29058/mjwbs.1616550 L1 - https://dergipark.org.tr/en/download/article-file/4506756 ER -