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A Clinical Study on Fistula-in-ano: A Comparative Study of Different Treatment Modalities in A Tertiary Care Hospital

Shiva Prasad Naik N , G Kishore Babu1 , Shiva Prasad Naik N2

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New Indian Journal of Surgery 10(6):p 581-585, November-December 2019. | DOI: DOI: https://dx.doi.org/10.21088/nijs.0976.4747.10619.4

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G Kishore Babu, Shiva Prasad Naik N. A Clinical Study on Fistula-in-ano: A Comparative Study of Different Treatment Modalities in A Tertiary Care Hospital. New Indian J Surg. 2019;10(5):581-585.

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Abstract

Context: Fistula-in-ano is an abnormal communication, lined by granulation tissue between the anal canal and the skin, which causes chronic inflammatory response. Surgery for fistula-in-ano is considered essential for decompression of acute abscesses and to prevent spread of infection. Treating anal fistula is a complex task because of anatomical location of disease, recurrence rate, potential risk of septic complications and postoperative fecal incontinence. Main objective of surgery is to heal the fistula and minimize the morbidity of disease. Many surgical techniques, fistulotomy, fistulectomy, Seton, LIFT and others used for treatment of fistula. Eradication of sepsis and maintenance of continence are two great challenges for the success of surgery. Aims: To study the incidence, etiology, clinical presentations and different treatment modalities for fistula-in-ano. Settings and Study design: Prospective analytical study, Study subjects and setting: 75 patients presenting with fistula-in-ano in Dept. of surgery SVRRGGH Tirupati. Study period: October 2017 to October 2018. Materials and Methods: In this study, 75 cases who underwent Fistula Surgery were taken Age, Sex, Complaints, Type of fistula, Type of surgery, Duration of hospital stay, Complications, Histopathological examination were noted for analysis. Statistical analysis used: SPSS11 Results: 80% Fistula-in-ano occur in men and around 30–50 years. Simple fistula is 84%, complex fistula 16%. Most common type is simple, low-level, posterior fistulas. Commonest presenting symptom is Discharge & Pain. Fistulectomy is the commonly done. Pain is the most common postoperative complication. Mean Hospital stay is 4–6 days. 7% of patients had recurrence in 3 months. Common etiology is non-specific. Conclusions: Fistula-in-ano is mostly due to crypto glandular infection. Diagnosis is by history, clinical examination, per rectal examination with discharging sinus and pain, histopathological examination of fistula tract. Most fistulas associated are non-specific etiology. Fistulectomy is better than fistulotomy because of complete healing and no recurrence after surgery.

Keywords: Fistula-in-ano; Fistulectomy; Fistulotomy; Seton; LIFT.

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G Kishore Babu, Shiva Prasad Naik N. A Clinical Study on Fistula-in-ano: A Comparative Study of Different Treatment Modalities in A Tertiary Care Hospital. New Indian J Surg. 2019;10(5):581-585.

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DOI: DOI: https://dx.doi.org/10.21088/nijs.0976.4747.10619.4

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