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Updated: Jun 25, 2026
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Vessel-sparing Excision and Primary Anastomosis
Published on: January 7, 2019
Risk factors for recurrence and incontinence after anal fistula surgery
J Jordán1, J V Roig, J García-Armengol
1Department of General and Digestive Surgery, Hospital Universitario de Tenerife, Spain.
Summary
Recurrence and incontinence after anal fistula surgery are influenced by fistula complexity and preoperative incontinence. Identifying internal openings and managing high fistulae are crucial for successful treatment outcomes.
Area of Science:
- Colorectal surgery
- Surgical outcomes
- Anal fistula management
Background:
- Fistula-in-ano presents significant therapeutic challenges.
- Understanding recurrence and incontinence risks is vital for patient management.
Purpose of the Study:
- To evaluate risk factors for recurrence and incontinence after anal fistula surgery.
- To identify predictors of poor surgical outcomes in fistula-in-ano patients.
Main Methods:
- Analysis of 279 patients undergoing anal fistula surgery with long-term follow-up.
- Multivariate analysis to determine statistically significant risk factors.
Main Results:
- 7.2% of patients experienced delayed healing or recurrence.
- Complex fistulae and non-identification of the internal opening were significant predictors of recurrence.
- Preoperative incontinence was a key risk factor for postoperative incontinence.
Conclusions:
- While overall recurrence rates are acceptable, high fistulae remain challenging.
- Internal opening identification is critical for successful surgical outcomes.
- Patients with preoperative incontinence are at higher risk of postoperative incontinence and require careful consideration.
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