Anal Fistula and Abscess

Prof. Carlo Ratto was born in Naples, Italy, on July 6, 1962. He completed his graduation in medicine and surgery at the Catholic University of Rome in 1987 and specialized in emergency surgery at the Catholic University of Rome in 1992. He is a colorectal surgeon, experienced in clinical and scientific research, training and educational support, and innovations in coloproctology. His clinical practice concerns particularly the colo-recto-anal disorders and diseases. He was coordinator of several scientific projects, with publication of results in prestigious scientific journals. He has been editor of books on different topics in coloproctology. He was Scientific Director and Member of Board of numerous training and master courses, meetings, and congresses. Prof. Ratto is an active member of the most prestigious scientific societies in coloproctology. He was frequently involved, as invited speaker, in a number of national and international congresses and meetings, and he hasalso performed “live surgery.” He is active member of – American Society of Colon and Rectal Surgeons (ASCRS), Fellow – European Society of Coloproctology (ESCP) – International Anal Neoplasia Society (IANS) Prof. Ratto was/is member of the several committees of the ASCRS. Prof. Ratto is member of the editorial board of several scientific journals.Dr. Angelo Parello was born in Agrigento, Italy, on October 17, 1980. He graduated with honors in medicine and surgery from the Catholic University of Rome in 2004. From 2004 to 2010, he was resident in general surgery at the Catholic University of Rome, which he attended with particular interest directed to diagnosis and treatment of coloproctological diseases. His clinical practice is mainly directed to diagnosis and treatment of colo-rectal-anal diseases, and he is an expert in performing both anorectal and pelvic floor diagnostics tests (e.g., anorectal manometry and endoanal and transrectal ultrasound) and treatment (e.g., transanal hemorrhoidal Doppler-guided dearterialization for hemorrhoidal disease, and sacral neuromodulation for fecal incontinence and constipation). Dr. Parello collaborated in the development of a novel minimally invasive surgical approach to treat fecal incontinence – THD implant Gatekeeper and SphinKeeper. He was teacher and tutor in many national and international courses conducted in Italy and other European countries. Dr. Parello is author of several scientific publications in international journals and author of several book chapters, and has presented his research resultDr. Francesco Litta was born in Matera on April 25, 1983. He graduated with honors in medicine and surgery from the Catholic University of Rome in 2008. He is a specialist in general surgery. Dr. Litta is a consultant surgeon in the Proctology Unit at the Foundation University Hospital “A. Gemelli,” IRCCS, Rome, Italy. His clinical practice focuses mainly on the diagnosis and treatment ofdisease of the colon and the rectum, and all proctological diseases. He is involved in anorectal physiology testing, with particular interest in the evaluation of benign and malignant disease by means of the anorectal manometry, three-dimensional endoanal ultrasound, and the high-resolution anoscopy. His research activity is mainly based on the evaluation and treatment of patients affected by anal fistula, fecal incontinence, constipation, hemorrhoidal disease, xii About the Editors obstructed defecation syndrome, and inflammatory bowel diseases, with studies concerning pathophysiology and surgical treatment by means of traditional and new minimally invasive therapeutic options. Dr. Litta is author of several scientific publications in international journals and author of several book chapters, and has presented his research results at national and international scientific conferences. He is teacher in a series of national and international courses on the management of coloproctological diseases. Dr. Litta is active member of the European Society of Coloproctology (ESCP), and member of the Guidelines Committee on the diagnosis and treatment of cryptoglandular perianal fistula, on behalf of this Society. Dr. Veronica De Simone was born in Avellino, Italy, on January 4, 1987. She graduated with honors in medicine and surgery from the Catholic University of Rome in 2011 (110/110 cum laude). She completed her training in general surgery at the Catholic University of Rome (2012–2017). She works in the Proctology Unit at the Foundation University Hospital “A. Gemelli,” Rome, Italy. Her clinical practice concerns the diagnosis and treatment of benign and malignant colorectal and anal diseases. She developed a particular expertise in the diagnosis and management of anal and perianal HPV-related disease, performing anal cancer screening and second-level diagnostic tests (high resolution anoscopy) in high-risk population (HIV+, transplant recipients, and inflammatory bowel diseases). She is expert in performing anorectal diagnostics tests (e.g., anorectal manometry, and endoanal and transrectal ultrasound), in particular for the diagnostic evaluation of patients affected by fecal incontinence, obstructed defecation, and anal fistula and abscess. She is also involved in multidisciplinary team for the diagnosis, treatment, and follow-up of patients affected by rectal and anal cancer. Her research activity is mainly based on the evaluation and treatment of patients affected by fecal incontinence, anal HPV-related diseases, and anorectal dysfunctional outcomes after rectal resection surgery. About the Editors xiii She is author of several scientific publications in international journals and has presented her research results at national and international scientific conferences. She is teacher in a series of national and international courses on the diagnosis and treatment of colorectal diseases.Dr. Paola Campennì was born in Vibo Valentia, Italy, on January 17, 1984. She graduated with honors in medicine and surgery from the University of Rome “La Sapienza” in October 2008 with an experimental research about transanal endoscopic microsurgery for rectal cancer. She worked as resident in the Digestive Surgery Unit at the University of Udine, and she focused on colorectal diseases and minimally invasive surgery at the University of Milan. In May 2015, she concluded her surgical training with honors and published her degree thesis. From 2016 to 2019, she worked at Humanitas Research Hospital, Rozzano (MI), as colorectal surgeon and at Humanitas University as clinical tutor for medicine and surgery students (course of SimulationLab: patients management). She is now a staff surgeon in the Proctology Unit at the Foundation University Hospital “A. Gemelli,” Rome, Italy, and consultant proctologist at Mater Olbia Hospital, Olbia, Italy. She is mainly dedicated to treatment of: – Proctological diseases (hemorrhoidal disease, anal fissure, anal fistula, anorectal abscess, proctitis, HPV infection, and anorectal dysplasia/cancer) – Chronic inflammatory bowel diseases (Crohn disease and ulcerative colitis) – Pelvic Disorders (complete rectal prolapse, internal intussusception, rectocele, obstructed defecation syndrome, and fecal incontinence) She routinely performs endoanal and transrectal ultrasound, anorectal manometry, and high-resolution anoscopy, and she is actively involved in the conservative treatment of fecal incontinence by the adoption of percutaneous tibial nerve stimulation (PTNS). xiv About the Editors She is author of several papers concerning functional disorders and rectal cancer. She is one of the founders of the Young Group of Italian Society of Colorectal Surgery (SICCR-Y), secretary from 2017 to 2019, and promoter of numerous multicenter studies.

• Anorectal Anatomy Related to Anal Fistula and Abscess.- Anorectal Physiology Related to Anal Fistula and Abscess.- Classification of Anal Fistula and Abscess: Useful Features to Address the Treatment.- Epidemiology of Anal Fistula and Abscess.- From Abscess to Fistula: Is This the Rule?.- Pathophysiology of Anal Fistula and Abscess: Old Concepts and New Insights.- Severity Scores for Anal Fistulas.- Unconventional insights into etiology of fistulas in the peri-anal region.- Clinical Assessment of Crohn’s Anal Abscess and Fistula.- Clinical Assessment of Cryptoglandular Anal Abscess and Fistula.- Anorectal Physiology Assessment in Patients With Anal Fistula: When Necessary?.- Endoanal Ultrasound in The Diagnosis of Cryptoglandular Anal Fistula and Abscess.- Future perspectives in The Diagnosis of Anal Fistula and Abscess.- Magnetic Resonance and Traditional Radiology in The Diagnosis of Cryptoglandular Anal Fistula and Abscess.- Magnetic Resonance in The Diagnosis of Crohn’s Anal Fistula and Abscess.- Utility and Limitations of Endoanal Ultrasound in The Diagnosis of Crohn’s Anal Fistula and Abscess.- Additional Surgical Options to Treat Anal Fistulas: Gracilis Interposition, Martius Flap, Gluteal Flap.- Anal Fistula: Actual Perspectives of Scientific Research Toward the Future.- Correct Use of Setons: Is There Any Agreement?.- Dermal Flap.- Fistula Laser Closure.- Fistulectomy.- Fistulotomy.- Flap.- Glue and Paste Injection.- How to Drain an Abscess.- Ligation of Intersphincteric Fistula Tract (LIFT).- Quality of Life Following Anal Fistula Treatment.- Risk Factors for Recurrence and Incontinence After Anal Fistula Surgery.- Stem Cells in Cryptoglandular Anal Fistulas.- Treatment by Over-The-Scope Clip.- Utility of Adding Marsupialization to Fistulotomy.- Utility of Adding Sphincter Reconstruction to Fistulotomy/Fistulectomy.- Video-Assisted Anal Fistula Treatment.- Evidences for optimal surgical management of anal fistulas and abscess.- Future directions in surgical approach of anal fistulas and abscess.- Integration of surgery with medical therapy in treating anal fistulas: when and how?.- New perspectives in the treatment of anal fistulas: stem cells.- Ostomy and Proctectomy to treat anal fistulas and abscess; when and why?.- Patients’ quality of life during and after treatment of anal fistulas and abscess.- Treatment of anal fistulas and abscess: when does surgery come first?.- Anastomotic dehiscence and fistulization.- Best Surgical Strategy to Treat Anal Fistula and Abscess: A Comprehensive Meta-Analysis of Literature.- Fournier Syndrome.- Real Practice in the Management of Anal Fistula and Abscess: Results of a Worldwide Survey as Related to the International Guidelines.- Recto-vaginal and recto-urethral fistulas.