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Fistula in ano

D Adams, P J Kovalcik

    Surgery, Gynecology & Obstetrics
    |November 1, 1981
    PubMed
    Summary
    This summary is machine-generated.

    Most anal fistulas stem from cryptoglandular issues and often have long-standing symptoms. Surgical treatment under spinal anesthesia is safe, though fistulotomy is linked to higher recurrence rates.

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    Area of Science:

    • Colorectal Surgery
    • Surgical Outcomes
    • Anal Fistula Etiology

    Background:

    • Fistula in ano is a common anorectal condition.
    • Cryptoglandular origin is the most frequent cause of anal fistulas.
    • Delayed diagnosis and treatment are common, leading to prolonged patient suffering.

    Purpose of the Study:

    • To review the outcomes of surgical management for fistula in ano.
    • To identify the primary causes and treatment strategies for anal fistulas.
    • To assess the safety and complication rates associated with surgical interventions.

    Main Methods:

    • Retrospective review of 133 patients diagnosed with fistula in ano over eight years.
    • Analysis of surgical procedures including fistulectomy and fistulotomy under spinal anesthesia.

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  • Evaluation of associated procedures and complication rates.

    • Main Results:

    • The majority of anal fistulas were found to be of cryptoglandular origin.
    • A significant number of patients experienced symptoms for over a year prior to surgery.
    • Surgical intervention under spinal anesthesia was performed safely, with fistulectomy and fistulotomy being the primary techniques. Associated procedures like hemorrhoidectomy were also safely performed.
    • Complications including early recurrence, spinal headache, bleeding, and temporary incontinence were observed in 14 patients, with all early recurrences linked to fistulotomy.

    Conclusions:

    • Cryptoglandular etiology is predominant in fistula in ano.
    • Surgical management of fistula in ano under spinal anesthesia is safe and effective.
    • Fistulectomy may be associated with lower recurrence rates compared to fistulotomy.