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Revista Mexicana de Coloproctología Enfermedades del Ano, Recto y Colon

2011, Number 1

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Rev Mex Coloproctol 2011; 17 (1)

To Analyze risk factors related to recurrence in the surgical treatment of anal fistula

Amarillo HA, Manson R, Fourcans S, Amarillo HR

Language: Spanish
References: 19
Page: 10-16
PDF size: 63.65 Kb.


ABSTRACT

Background: Recurrence and incontinence are the two more important aspects about surgical treatment of fistula-in-ano. Its treatment is probably one of the most challenging situations in anal surgery. Objective: To analyze risk factors related to recurrence in anal fistula treated by any surgical procedure. Setting: Colorectal Unit, Sanatorio Modelo, Tucuman. Design: Retrospective consecutive series; period 2000-2009. Population: 15 recurrences after surgery. Methods: 170 consecutive cases in an elective basis. Variables: Age, sex, MCI, smoking, diabetes, location, surgical technique, type, number and time of recurrence, immediate and late morbility and incontinence. This series was matched with global one. Excel Vista prospective bases was used and statistical SPSS10.0 software considering significance when p ‹ 0.05. Results: 15 recurrences (8.8%). Age: 49 years (35-63), 14/1 (M/F), all were criptoglandular. According to type, 2 were simple and 13, complex. Follow up was possible in 92%. Immediate soiling was 50% and late disturbes in continence were reported in 4 cases. Surgical techniques used were: fistulotomy, seton, mucosal advance. Conclusions: Incidence of recurrence was similar to literature and more frequent in complex fistula. Functional outcome was good, although half of patients reported soiling. There was not only one clear risk factor associated to recurrence. Young male with complex fistula, particularly high transphinteric, located posteriorly, with more than one risk factor and with previous surgery performed by non-specialist are related with high incidence of recurrence.


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