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©The Author(s) 2016.
World J Gastrointest Surg. Jul 27, 2016; 8(7): 513-520
Published online Jul 27, 2016. doi: 10.4240/wjgs.v8.i7.513
Published online Jul 27, 2016. doi: 10.4240/wjgs.v8.i7.513
Table 1 Gynecological history and past perianal surgery
n = 70 (n females = 19) | % | |
Females with vaginal deliveries | 9 | 47.3 |
Episiotomy | 4 | 21.0 |
Hysterectomy | 2 | 10.5 |
Perianal abscesses drained | 42 | 60.0 |
Seton | 22 | 31.4 |
Fistulotomy | 6 | 8.6 |
Fistulectomy | 3 | 4.3 |
LIS | 7 | 10.0 |
Hemorroidectomy | 3 | 4.3 |
Rectal mucosal advancement flap | 3 | 4.3 |
Table 2 Results of fistula evaluation in 70 patients n (%)
PE | 2D-EAUS | 3D-EAUS | Surgery | |
IO identified | 3 (75.7) | 67 (95.7) | 67 (95.7) | 67 (95.7) |
Primary tract | ||||
Intersphincteric | 19 (27.1) | 14 (20) | 10 (14.3) | 13 (18.6) |
Transsphincteric | ||||
Low | 22 (31.4) | 25 (35.7) | 34 (48.6) | 33 (47.1) |
High | 19 (27.1) | 30 (42.9) | 25 (35.7) | 24 (34.3) |
Unclassified | 10 (14.3) | 1 (1.4) | 1 (1.4) | 0 (0) |
Secondary tract | 6 (8.6) | 15 (21.4) | 16 (22.9) | 11 (15.7) |
Adjacent abscesses | 12 (17.1) | 17 (24.3) | 19 (27.1) | 8 (11.4) |
Table 3 Concordance grade and k coefficient (k) between intraoperative findings and the different diagnostic techniques used
PE | 2D-EAUS | 3D-EAUS | ||||
Concordance | k | Concordance | k | Concordance | k | |
IO identified | 51/70 (72.8%) | 1 | 68/70 (97.1%) | 1 | 68/70 (97.1%) | 1 |
Primary tract | 37/70 (52.9%) | 0.33 | 55/70 (78.6%) | 0.67 | 58/70 (82.8%) | 0.75 |
Secondary tract | 61/70 (87.1%) | 0.44 | 64/70 (91.4%) | 0.66 | 65/70 (92.8%) | 0.60 |
Adjacent abscesses | 58/70 (82.8%) | 0.30 | 61/70 (87.1%) | 0.57 | 60/70 (85.7%) | 0.54 |
Table 4 Efficacy parameters in relation to surgery for the different diagnostic techniques: Sensitivity, specificity, positive predictive value and negative predictive value
S | SP | PPV | NPV | ||
IO identified (%) | PE | 76 | 33 | 96 | 6 |
2D-EAUS | 98 | 66 | 98 | 66 | |
3D-EAUS | 98 | 66 | 98 | 66 | |
Primary tract (%) | |||||
Intersphincteric | PE | 69 | 82 | 47 | 92 |
2D-EAUS | 77 | 93 | 71 | 95 | |
3D-EAUS | 22 | 98 | 90 | 93 | |
Transsphincteric | |||||
Low | PE | 45 | 81 | 68 | 67 |
2D-EAUS | 67 | 92 | 88 | 75 | |
3D-EAUS | 85 | 84 | 82 | 86 | |
High | PE | 38 | 87 | 68 | 78 |
2D-EAUS | 64 | 76 | 70 | 70 | |
3D-EAUS | 88 | 91 | 84 | 93 | |
Secondary tract (%) | PE | 40 | 97 | 67 | 91 |
2D-EAUS | 90 | 90 | 60 | 98 | |
3D-EAUS | 90 | 88 | 56 | 98 |
Table 5 Results of receiver operatives characteristic curves for the diagnosis of transsphinteric fistulas
Area under curve | 95%CI | P value | ||
Low transsphincteric fistula | PE | 0.608 | 0.474-0.742 | 0.120 |
2D-EAUS | 0.819 | 0.714-0.924 | 0.0001 | |
3D-EAUS | 0.829 | 0.724-0.934 | 0.0001 | |
High transsphincteric fistula | PE | 0.672 | 0.541-0.803 | 0.019 |
2D-EAUS | 0.842 | 0.745-0.939 | 0.0001 | |
3D-EAUS | 0.910 | 0.835-0.985 | 0.0001 |
- Citation: Garcés-Albir M, García-Botello SA, Espi A, Pla-Martí V, Martin-Arevalo J, Moro-Valdezate D, Ortega J. Three-dimensional endoanal ultrasound for diagnosis of perianal fistulas: Reliable and objective technique. World J Gastrointest Surg 2016; 8(7): 513-520
- URL: https://www.wjgnet.com/1948-9366/full/v8/i7/513.htm
- DOI: https://dx.doi.org/10.4240/wjgs.v8.i7.513