Comparative analysis of early and late recurrence rates in perianal fistula surgery

Perianal fistulas (PAF) represent a complex anorectal condition characterized by marked therapeutic and surveillance challenges. Due to its high propensity for recurrence, sustained long-term follow-up is as important for patient management as the initial intervention. The present analysis included 245 patients who underwent surgical treatment for PAF. Patient data were examined from the early postoperative period onward. Follow-up data at 1, 6 and 24 months were obtained by reviewing operating room, inpatient ward and outpatient clinic records. Patients lost to follow up, whether due to non-attendance at scheduled outpatient visits or inability to be contacted, were not excluded from the analysis; rather, this subgroup was categorized separately to assess the characteristics and potential impact of the missing data. Results indicated that MRIs demonstrated a high diagnostic success rate for PAF (90.95%). By contrast, retrospective clinical examination proved insufficient for accurately identifying the internal fistula opening. In long-term assessment, both fistulectomy and seton placement yielded comparable success rates. A progressive increase in missing data was observed throughout the follow-up period. Overall, MRI remains an established diagnostic modality for PAF. Long-term therapeutic outcomes are not determined solely by surgical technique, but rather by a complex interplay of factors. These include gaps in key anatomical data, socioeconomic barriers contributing to patient attrition, cultural perspectives on healthcare and the growing influence of social media in shaping patient expectations and health-associated anxieties. All these elements markedly influence the clinical pathway and ultimate success of PAF management.