A 30 YEAR EXPERIENCE IN THE MANAGEMENT OF ANAL FISTULA.

• Main Author: Doureid Oueidat
• Format: Article
• Language: English
• Published: Associazione Italiana Giovani Medici 2017-12-01
• Series: Euromediterranean Biomedical Journal
• Subjects: Anal fistula; fistulotomy; seton; anal plugging
• Online Access: http://www.embj.org/joomla335/index.php?option=com_k2&view=item&id=321:management-anal-fistula&Itemid=17

Anal fistula has been recognized for centuries, and yet, its treatment remains a challenge for surgeons till today. In this study, a 30 year experience of treating anal fistula is being reported and discussed in light of the various recognized management methods. A total of 320 patients were treated by fistulotomy, fistulectomy, fistula plugging or seton technique. Data showed that fistula plugging carried the highest failure rate (89%) seconded by fistulectomy (37%), seton procedure (24.5%) and fistulotomy (15.6%). High transsphincteric fistulas were more likely to predict failure compared to low transsphincteric, intersphincteric and subcutaneous fistulas (37.5% versus 9.5%, 7.3% and 0%, respectively). In conclusion, the scales seem to support fistulotomy. However, no standardized algorithm exists to guide the care of patients and the choice of operation is based on patient-related factors, the patient’s surgical history, and the surgeon’s experience and familiarity with the various techniques for treating anal fistula.