Fistulotomy Versus Fistulectomy As a Primary Treatment of Low Fistula in Ano
Iraqi Postgraduate Medical Journal,
2012, Volume 11, Issue 4, Pages 510-515
Fistula in ano is common surgical condition that is treated by different surgical modalities.
Is to compare the outcome and complications of fistulotomy and fistulectomy as primary treatment of low fistula in ano.
PATIENTS AND METHODS:
A prospective randomized study was done on 76 patients of low fistulae in ano who were admitted to the surgical department at Alkindy teaching hospital from January 2009-January 2010.
Fistulotomy was done in 32 patients, and fistulectomy was done in 44 patients.
Patients were followed up post operatively for one year and the healing time was estimated in both groups and complication rate was recorded including bleeding, infection, incontinence and recurrence.
Out of 76 patients included in this study,65 patients( 85.53%) were found intraoperatively to have intersphincteric fistulae and 11 patients(14.47%) were low tansphincteric fistulae.
The operating time for fistulotomy (15-25 minutes) was shorter than that for fistulectomy (20-35 minutes).
The healing time was found to be shorter in fistulotomy group (26.38 days) than that of fistulectomy(38.64 days).
The complications which were recorded include bleeding occurred in only one out of 44 patients (2.27%) following fistulectomy, while no bleeding developed following fistulotomy.
Infection developed in one case out of 32 (3.12%) following fistulotomy and one case out of 44 (2.27%) following fistulectomy.
Two cases out of 32 (6.25%) developed minor incontinence following fistulotomy and 5 cases out of 44 (11.36%) following fistulectomy.
Recurrence developed in 2 cases out of 32 (6.25%) of fistulotomy and 3 cases out of 44 (6.82%) following fistulectomy. The recurrence in both groups developed within 4-6 weeks following surgery.
Fistulotomy can be used as a primary treatment of low fistula in ano as the operating time is shorter and it takes shorter period of time for the wound to heal and the incidence of complications is comparable to that of fistulectomy.
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