Anal Fistula and Abscess

This volume comprehensively describes the anatomy, pathophysiology, diagnostics, and modalities of treatment of one of the most complex and debated clinical conditions in coloproctology: anal fistulas and abscesses. It also debates current controversies and presents the best approaches based on the authors’ clinical expertise. Providing an in-depth understanding of the anal canal anatomy and surrounding area, it enables readers to manage anal sepsis and avoid excessive damage, in particular to the anal sphincters. Further, the book presents insights into the pathophysiological processes (in cryptoglandular and Crohn’s disease) causing abscess and fistula, which have a significant impact on the management of these conditions. It also discusses diagnostic assessments crucial for selecting the optimal surgical technique and offers guidance on the timing. Lastly, it assesses the pros and contras of the various surgical procedures, evaluating the possible outcome in terms of both therapeutic success and detrimental effects on the anorectal functions. As such it is a valuable resource for all physicians involved in the management of anal fistulas and abscesses (coloproctologists, general surgeons, gastroenterologists, radiologists). 

Carlo Ratto is a researcher at the Department of Surgical Sciences, Catholic University, Rome. His clinical practice at the Division of Chirurgia Digestiva, Department of Surgical Sciences at the University (Policlinico "A. Gemelli"), focuses on colo-recto-anal disorders. He is actively involved in research on: colorectal cancer anal cancer, anorectal physiology (concerning anorectal manometry, electrophysiology studies, endoanal ultrasound in benign anorectal disorders), fecal incontinence and constipation, hemorrhoids, fistula-in-ano, rectocele. He is the author of a number of publications in international journals and presented his research at national and international scientific meetings. He is a member of the American Society of Colon and Rectal Surgeons (ASCRS), European Society of Coloproctology (ESCP), Italian Society of Colorectal Surgery (SICCR), Italian Society of Surgery (SIC), and the Italian Society of Oncologic Surgery (SICO).

Angelo Parello works at the Proctology Unit, Dept. of Abdominal Surgery, Foundation University Hospital “A. Gemelli”, IRCCS, Catholic University. His clinical practice is mainly directed to diagnosis and treatment of colo-rectal-anal diseases, and he has expertise in performing ano-rectal and pelvic floor diagnostics tests (e.g. anorectal manometry and endoanal and transrectal ultrasound) and treatment. He is an active member of the Italian Society of Colorectal Surgery (SICCR) and is the author of several publications in international journals and numerous book chapters. He has also presented his research at national and international scientific conferences.

Francesco Litta is an attending physician at the Proctology Unit of the Foundation University Hospital “A. Gemelli”, Rome, Italy, directed by Prof. Carlo Ratto. His clinical practice focuses mainly on the diagnosis and treatment of diseases 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 using anorectal manometry and three-dimensional endoanal ultrasound. . 
He is active member of the Italian Society of Colorectal Surgery (SICCR).

Veronica De Simone works at the Proctology Unit of the Foundation University Hospital “A. Gemelli”, Rome, Italy, directed by Prof. Carlo Ratto.  Her clinical practice focuses on the diagnosis and treatment of benign and malignant colorectal and anal diseases. She has 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 populations (HIV+, transplant recipients, inflammatory bowel diseases). She is active member of the Italian Society of Colorectal Surgery (SICCR) and of the International Anal Neoplasia Society (IANS).

Paola Campennì  is a surgeon of the Proctology Unit of the Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome.  From 2016 to 2019 she worked at Humanitas Research Hospital, Rozzano (MI) as colorectal surgeon and at Humanitas University as clinical tutor of Medicine and Surgery students (course of SimulationLab: patients management).
Her activity is mainly  dedicated to the  treatment of chronic inflammatory bowel diseases  , pelvic disorders,  proctological diseases. 
She routinely performs endoanal and transrectal ultrasound, anorectal manometry, high resolution anoscopy, and she is actively involved in the conservative treatment of feacal incontinence by the adoption of percutaneous tibial nerve stimulation (PTNS).
She is author of several papers concerning functional disorders and rectal cancer.
Dr .Campennì  is one of the founders of Young Group of Italian Society of Colorectal Surgery (SICCR-Y), secretary from 2017 to 2019 and promoter of numerous multicenter studies.