Anal fistulotomy with radiofrequency: a better option to a conventional procedure

Even after the availability of many different surgical options, most surgeons still prefer the classical lay open technique (fistulotomy) as the gold standard for the treatment of anal fistula. This study analyzes the procedure and outcome of radiofrequency fistulotomy over the conventional scalpel method.

Fifty patients with low fistula in ano were analyzed in a prospective study. They were randomized into conventional and radiofrequency fistulotomy groups. Parameters measured included time taken for the procedure, amount of blood loss, postoperative pain, period taken for return to work and recurrence rate. The patients were followed over a period of 30 months.

The average time for complete wound healing was 49 days. The patients took a mean period of 7 days to return to their routine. In 7 patients the wounds took more than 80 days to heal and were labeled as delay in wound healing. Two patients developed a recurrence. The comparative study between conventional and radiofrequency fistulotomy showed that procedure time was shorter (p= 0.001); intra operative bleeding was much less (p=0.0004), return to work was earlier (p= 0.029) and wound-healing time was shorter (p=0.0017) in radiofrequency procedure.

In terms of parameters set for the study, the radiofrequency technique was found to have significant advantages over conventional fistulotomy procedure with regard to operation time, blood loss, return to normal activity and healing of the wounds.