Formation rate of secondary anal fistula after incision and drainage of perianal Sepsis and analysis of risk factors

Abstract

Background: The choice of surgery for perianal sepsis is currently controversial. Some people advocate one-time radical surgery for perianal sepsis, while others advocate incision and drainage. The objective of this study is to observe the formation probability of secondary anal fistula after incision and drainage in patients with perianal sepsis and determine factors that contribute to secondary anal fistula after incision and drainage. Methods: A retrospective descriptive analysis was conducted in 288 patients with perianal sepsis who were treated with anorectal surgery in the Suzhou Hospital of Traditional Chinese Medicine from January 2016 to June 2018. The patients were followed by telephone, physical examination, and pelvic MRI examination for at least 1 year after surgery. Results: Three patients were not followed, 98 patients did not receive surgical treatment or one-time radical surgery for perianal sepsis, and 187 patients were ultimately identified for the study. Anal fistula was present in 105 patients, and the rate of formation of secondary anal fistula was 56.15%. There was no statistically significant difference in the fistula formation rate between different types of sepsis (P>0.05). And, in patients with secondary anal fistula, there was no significant correlation between the location of sepsis and the type of secondary anal fistula (P>0.05). Conclusions: The incidence of secondary anal fistula after incision and drainage of perianal sepsis is 56.15%, which is lower than the incidence found in previous study. Young is a risk factor for secondary anal fistula after incision and drainage of perianal sepsis. There is no significant correlation between the location of sepsis and the type of secondary anal fistula. Simple incision and drainage is a suitable choice for patients with acute perianal sepsis.

Histoacryle Injection VS. Silver Nitrate Injection in Treatment of Low Non Branching Anal Fistula

“…Hazards of fistula are too many ranging from distressing symptoms (pain, swelling, and discharge that can cause skin irritation, excoriation, and pruritus, sepsis and inflammation that affect quality of life significantly). The lack of any standard surgical procedure and heterogeneity of anorectal fistula warrants the surgeon to use his "judgment" more than in most colorectal diseases (19) .…”

No Difference in the Pathogenic Microorganisms Among Different Types of Anorectal Abscesses: A Retrospective Study

“…Current guidelines recommend adjunctive antibiotic therapy for anorectal abscesses in patients with comorbidities of cellulitis, diabetes, immunosuppression, or signs of sepsis [2]. Anorectal abscesses are prone to recurrence or secondary anal fistula formation after incision and drainage alone, and our previous study found the incidence of secondary anal fistula after incision and drainage of anorectal abscess to be 56.15% [4]. Literature reports that the use of antibiotics after incision and drainage of anorectal abscesses reduces the rate of fistula formation.…”

Long term efficacy of Video‐Assisted Anal Fistula Treatment (VAAFT) for complex fistula‐in‐ano: a single‐centre Australian experience

“…FIA has modest prevalence at approximately 1/10000 population with a male predilection as demonstrated in international epidemiological studies 1 though incidence is known to complicate perianal abscess management in a high number (35-56%) of cases. 2,3 The most common aetiology is idiopathic involving cryptoglandular infection. The pathophysiology of this process is thought to involve the obstruction and subsequent infection of anal glands located along the dentate line within the anal canal.…”

“…Fistula‐in‐ano (FIA) is a debilitating disease of the anorectum which involves the formation of a chronic inflammatory epithelialized tract between the anorectal canal and the anoderm of the perianal skin. FIA has modest prevalence at approximately 1/10000 population with a male predilection as demonstrated in international epidemiological studies 1 though incidence is known to complicate perianal abscess management in a high number (35–56%) of cases 2,3 . The most common aetiology is idiopathic involving cryptoglandular infection.…”