Anal fistula: results of surgical treatment in a consecutive series of patients

Abstract

Objectives:To evaluate the results of surgical treatment of patients with anal fistulas in a consecutive series of patients. Methods: A retrospective analytical study of a consecutive series of cases prospectively collected. The sample comprised 210 patients who underwent surgery; demographic data, signs and symptoms, intraoperative classification of the fistulas and healing time were analyzed. results: The median age was 38 years and 69.0% of the patients were male. The most frequent symptom was perianal orifice with purulent drainage. The fistulas were classified as transsphincteric in 60.9% and the most used operative treatment was the marsupialization of fistulotomy, in 84.2% of cases. Complete healing occurred in all patients between 2 and 16 weeks. One hundred and seventy-eight patients, 84.8% of the patients who underwent surgery, were evaluated at least one year after surgery and recurrence occurred in 6.4% of cases. Conclusions: There was male prevalence (2.2/1), and most fistulas were transsphincteric. The marsupialization of fistulotomy was the most used operative treatment, and it presented acceptable low rates of morbidity and recurrence of 6.4%.Keywords: fistula; rectal fistula; surgery; classification; surgical treatment, operative. resuMO: Objetivos: Avaliar os resultados do tratamento cirúrgico de pacientes portadores de fístulas anais em uma série consecutiva de pacientes. Métodos: Estudo analítico, retrospectivo, de uma série consecutiva de casos que foram coletados de forma prospectiva. A casuística englobou 210 pacientes operados, tendo sido analisados os dados demográficos, os sinais e sintomas, a classificação transoperatória das fístulas e o tempo até a cicatrização completa. resultados: A mediana de idade foi de 38 anos e 69,0% dos pacientes eram homens. O sintoma mais frequente foi a drenagem de secreção purulenta por orifício perianal. As fístulas foram classificadas como transesfincterianas em 60,9%, e o tratamento operatório mais empregado foi a fistulotomia com marsupialização do trajeto fistuloso, em 84,2% dos casos. A cicatrização completa ocorreu em todos os pacientes entre 2 e 16 semanas. Cento e setenta e oito pacientes, 84,8% dos pacientes operados, foram avaliados com, pelo menos, um ano de pós-operatório e a recidiva ocorreu em 6,4% dos casos. Conclusões: Houve prevalência do gênero masculino (2,2/1) com a maioria das fístulas transesfincterianas. A fistulotomia com marsupialização foi o tratamento operatório mais empregado e apresentou baixos índices de morbidade, com recidiva de 6,4%.

A descriptive analysis of management of fistula-in-ano

“…Seton has low rate or recurrence and was nil in the present study it causes minimal damage to the sphincter mechanism and is preferred in high fistulas (Table 1). 8,9 In this study, 66% of patients had low level of fistula-inano and another, 34% of patients had a high level of fistula-in-ano. A study done by Jethva et al, also observed that higher number of patients had fistula-in-ano of low level.…”

Efficacy of 0.2% GTN in Reducing Duration of Wound Healing after Fistulectomy

“…However, in this study male gender was dominant in both groups and overall mean age was 31+2.3 years. Similarly, Oliveira PG et al 9 reported that the patient's median age was 38 years with rage of 12 to 78 years and most of the cases 62.8% were observed with age group of 30 to 40 years. The predominant gender was male (69.0%), in a ratio of 2.2:1.…”

“…Fistula is an abnormal pathway that conveys two epithelized surfaces; if there should arise an occurrence, it associates the region anorectal to the skin. 8 This illness is highly prevalent among men and influenced primarily individuals in the age of 30 to 40 years and most commons symptoms of the inflammatory tumor are pain and purulent drainage. However, in this study male gender was dominant in both groups and overall mean age was 31+2.3 years.…”

The Value of Cutting Seton for High Transsphincteric Anal Fistula in the Era of Its Misery

“…Anal fistulas represent an essential aspect of colorectal practice, emerging as a distressing condition for patients and sometimes imposing a challenge upon surgeons. They have been classified into four significant types according to their relation to the anal sphincter complex, which include intersphincteric, transsphincteric, suprasphincteric and extrasphincteric ( 3 , 8 ). This classification is a means of helping to improve the management plan.…”

“…This classification is a means of helping to improve the management plan. Treatment strategies should incorporate a closure of the internal opening and an excision of the infected fistula tract with preservation of the sphincter complex ( 3 , 5 , 8 – 10 ).…”