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There is a paucity of data published on the progression of high-grade AIN to invasive cancer as well as on clinical and virological characteristics comparing anal margin and anal canal carcinoma. Methods: Detection of anal carcinoma and AIN was performed using cytology, high-resolution anoscopy, and histology in case of abnormal findings. In contrast to the cancer biopsies, a broad spectrum of surface high- and low-risk HPV types was found in anal swabs of the patients. Surgical excision resulted in long-term disease control of all anal margin carcinomas, whereas combined chemoradiotherapy in carcinomas of the anal canal was associated with high recurrence rates, high toxicity, and high mortality.
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Cutting seton versus two-stage seton fistulotomy in the surgical management of high anal fistula

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Cutting seton versus two-stage seton fistulotomy in the surgical management of high anal fistula

The study aims to elucidate the pathogenesis of an increasingly prevalent disease, as well as to update treatment and prognosis. A literature search in Pubmed database, including articles from to and cross-research articles with the initial research. Several studies prove the role of HPV as a major risk factor in the development of squamous cell carcinoma of anal canal, as well as a greater prevalence of this neoplasia in HIV-positive people and in those who practice receptive anal intercourse. In the last two decades chemoradiotherapy remains the treatment of choice, and abdominoperineal resection is reserved for those cases of treatment failure or recurrence. Evidence advances in order to adapt the treatment to each patient, taking into account individual prognostic factors and biological tumor characteristics. Squamous cell carcinoma of the anal canal is a neoplasm associated with HPV; therefore, screening and vaccination programs of male individuals, by way of prevention, should be started.
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Background: The aim of this study was to compare the clinical results obtained with the cutting seton and the two-stage seton fistulotomy TSSF in the surgical management of high anal fistula. There was no difference between the groups in age, sex distribution, or estimated percentage of anal sphincter involved by the fistula. Follow-up was by a mailed questionnaire inquiring about fistula recurrence, incontinence, and degree of satisfaction. Mean follow-up was similar in both groups 27 months for cutting seton versus 33 months for TSSF. Comparisons were made by Student t and chi 2 tests, as required.
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