Anal fistulotomy using radiowaves- long-term outcome

The aim of this paper was to analyze the results of treatment of anal fistulas using a radiowave device retrospectively.

Between 2000 and 2008, 976 patients were operated on for perianal fistula. A Ellman radiowave generator was used to carry out the complete surgical procedure. In the follow-up period 155 patients were lost, remaining 821 patients were analyzed in the study. The mean follow-up time was 6.8 years. Analyzed parameters included: postoperative complications, wound healing time, off work duration, recurrence rate and incidence of anal sphincter dysfunction. Severity of gas and stool incontinence was assessed.

In our study, subcutaneous fistula was diagnosed in 28.1%, inter-sphincteric in 39.1%, and trans-sphincteric in 32.8%; supra-sphincteric and extra-sphincteric fistulae were not included in the study. Single-tract fistulas were present in 85.4% and multi-tract fistulas were present in 14.6%. Postoperative complications were noticed in 1.4% of patients, which included postoperative bleeding, abscess formation, premature approximation of skin edges, prolapse of hemorrhoids and local skin allergic reactions. Postoperative gas and/or stool incontinence was noticed in 3.8%. The recurrence rate was 1.7%.

Radiowave fistulotomy offers short operation time, less postoperative pain, early return to normal activity, and faster healing of the wound. The recurrence rate and continence disturbances are comparable to conventional fistulotomy procedures.