Assessment of Fistulectomy Combined With Sphincteroplasty in the Treatment of Complicated Anal Fistula; [Avaliacao De Fistulectomia Combinada Com Esfincteroplastia No Tratamento De Fistula Anal Complicada] Publisher



Anaraki F¹ ; Etemad O² ; Abdi E³ ; Bagherzadeh G¹ ; Behboo R⁴ Show Affiliations
Source: Journal of Coloproctology Published:2017

Abstract

Introduction: The ideal method of treating the complex anal fistula is to eradicate the sepsis and preserve the anal sphincter; since there is no definite consensus on the surgical method of treating it. Recent studies show that fistulectomy and immediate sphincteroplasy are asafe and appropriate way to treat the fistula-in-ano. The aim of this study was to evaluate the long term outcomes of fistulectmy and sphincteroplasty in the treatment of complexperianal fistula. Methods: In this prospective study, we have analyzed the data of 80 patients who under wentfistulectomy and sphincteroplasty from May 2013 to May 2016. Preoperative information included physical examination, preoperative fecal incontinence evaluation and taking a complete history about underlying diseases and past related surgeries were collected. Results: Of all 80 patients with complex fistula, 57.5% (46 patients) were male. 70-Patientswere presented with high transsphincteric fistula (87.5%) and anterior fistula was diag-nosed in 10 of them (12.5%). 9 patients (11.3%) suffered from hypertension and 43 patients(53.75%) had recurrent fistula after previous surgeries. During the follow-up period, the over-all success rate was 98.8% (98.8%) and fistulectomy and sphincteroplasty failed in only onepatient (failure rate: 1.3%). preoperative and post-operative scoring showed mild fecal incon-tinence in 8 patients (10%). We have found no significant relation between the age, gender, hypertension, previous surgery and post-operative recurrence. Conclusion: Fistulectomy and sphincteroplasty is a safe surgical procedure in the treatment of anterior anal fistula in females and high transsphincteric fistulas. © 2017 Sociedade Brasileira de Coloproctologia.