‘An Observational Study on Surgical Outcome Predictors In Patients With Anal Fistula’
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 7, Pages 4748-4755
AbstractBackground- Anal sepsis is one of the most prevalent benign ano-rectal disorders and is one of the conditions that surgeons encounter frequently. A chronic or recurrent anal fistula may develop in up to 65% of patients who initially present with a perianal abscess.
Methodology- Retrospective Abstracted data included demographics, surgical history, type of fistula, number of fistula tracts, baseline continence, type of procedure, and post-operative complications, including septic complications and incontinence. Fistulas were classified by anal sphincter involvement as subcutaneous (no sphincter), intersphincteric (internal sphincter), low transsphincteric (50% of external sphincter), high trans-sphincteric (50% of external sphincter), or suprasphincteric (above the entire external sphincter).
Results - One hundred patients underwent an anal fistula operation during the study period. The median age was 45 years with a predominance of male patients (79%).53 days were the average follow-up. A higher risk of postoperative faecal incontinence was associated with horseshoe fistula (44%) compared to non-horseshoe fistula (13%).
Conclusion- Anal fistula surgery eliminates disease, preserves continence, and reduces morbidity. The study's scales favour fistulotomy. Anal fistula plugging had higher failure and disease persistence than fistulotomy and endorectal advancement flap. Postoperative infections were most common after plugging. Postoperative incontinence is more likely in patients over 45 with high fistulas. These findings can help surgeons choose the right operation for each anal fistula patient
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