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Anal fistulotomy between Skylla and Charybdis
M Westerterp1, N A Volkers, R W Poolman
1Lucas Andreas Ziekenhuis Amsterdam, Amsterdam, The Netherlands. m.westerterp@amc.uva.nl
Objective:
This study was undertaken to assess the results of anal fistulotomy on faecal continence, recurrence and satisfaction.
Methods:
We reviewed the records of 60 patients who underwent anal fistulotomy between 1997 and 2000. Follow-up was by a questionnaire with 46 (77%) patients responding. Mean follow-up was 1-4 years. Fistulas were intersphincteric in 12 patients and transsphincteric in 34 patients. Operative procedure consisted of fistulotomy.
Results:
Of 11 patients with high fistula, 9 (82%) had impaired continence; Of 17 patients with midanal fistula, 4 (24%) suffered impaired continence. Eighteen patients had a low fistula and 8 (44%) developed impaired continence. In the whole group 50% had suffered faecal incontinence. There were no recurrences and there was satisfaction with the situation in 87% of patients.
Conclusions:
Fistulotomy for primary fistula in ano in this retrospective study with a follow-up up to 4 years was associated with no recurrences. Eighty-two percent of patients with a high anal opening have impaired faecal continence, nevertheless patients' satisfaction is high.
