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Fistula development after anal abscess drainage-a multicentre retrospective cohort study
Daniel Mark Skovgaards1, Helene Perregaard2, Christian Bakholdt Dibbern3
1Digestive Disease Center, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark. danielskovgaards@gmail.com.
International Journal of Colorectal Disease
|December 13, 2023
Summary
Identifying risk factors for anal fistulas after abscess surgery is crucial. Factors like abscess location, Crohn's disease, recurrent abscesses, and high C-reactive protein increase fistula risk.
Area of Science:
- Gastroenterology and surgical research.
- Proctology and anal pathology.
Background:
- Anal abscesses are common surgical emergencies.
- Fistula formation is a significant complication following anal abscess treatment.
- Limited research exists on specific risk factors for anal fistula development post-surgery.
Purpose of the Study:
- To identify clinical risk factors associated with the development of anal fistulas after surgical drainage of anal abscesses.
- To provide data that can inform patient selection for specialized follow-up and early diagnosis.
Main Methods:
- A multicenter, retrospective cohort study was conducted in the Capital Region of Denmark.
- Patients undergoing acute anal abscess surgery between 2018-2019 were identified using ICD-10 codes.
- Clinicopathological factors and postoperative outcomes were extracted from patient records.
Main Results:
- Out of 475 patients, 33.7% developed anal fistulas at a median follow-up of 1108 days.
- Risk factors identified include low intersphincteric/ischioanal abscesses, Crohn's disease, recurrent anal abscesses, repeat surgery, E. coli-positive cultures, and elevated preoperative C-reactive protein (>100 mg/L).
Conclusions:
- Several clinical factors significantly predict fistula development after anal abscess surgery.
- These findings have implications for targeted patient management and potentially reducing prolonged treatment durations.
- Further research may refine risk stratification and preventative strategies.
