Clinical Study of Various Modalities of Treatment for Fistula in Ano in Haryana Population

  • Sumesh Kumar Garg Adesh Medical College and Hospital, Ambala, Haryana, India
  • Sandeep Arora Pacific Institute of Medical Sciences, Udaipur, Rajasthan, India
  • Perveez Ahmad Malik Adesh Medical College and Hospital, Ambala, Haryana, India
Keywords: Fistulectomy, Fistulogram, Fistulotomy, Sphincter sparing

Abstract

Background: Fistula ano has been known as a common surgical ailment for over two and half a millennia. It is characterized by
purulent drainage or cyclic pain associated with abscess re-accumulation followed by intermittent spontaneous decompression.
There are many techniques to treat the fistula.
Materials and Methods: Ninety-two adult patients having fistula in ano were studied. PR examination, proctoscopy, and fistulogram
were done to for planned surgical treatment. All pre-operative routine blood examination was carried out. Patient was kept nil by
mouth since previous night, surgery was done under appropriate anesthesia and dissected parts were sent for histopathological
examination, based on histopathological report patients treated postoperatively.
Results: Eighty-six (93.4%) had perianal discharge, 69 (75%) had history of perianal abscess, 27 (29.6%) had pain, 89 (96.7%)
had swelling, 65 (70.6%) had fistulectomy, 11 (11.9%) had fistulotomy, 16 (17.3%) had seton thread technique, and recurrence
was in 4 (4.34%) patients.
Conclusion: Fistulotomy is associated with slightly high rate of recurrence but low chances of anal incontinence; it has shorter
operating time with less post-operative pain and less time needed for wound healing as compared to fistulectomy.

Author Biographies

Sumesh Kumar Garg, Adesh Medical College and Hospital, Ambala, Haryana, India

Assistant Professor, Department of Surgery

Sandeep Arora, Pacific Institute of Medical Sciences, Udaipur, Rajasthan, India

Associate Professor, Department of Anatomy

Perveez Ahmad Malik, Adesh Medical College and Hospital, Ambala, Haryana, India

Assistant Professor, Department of Surgery, 

References

Ramanujam PS, Prasad ML. Perinanal abscess and fistula a study

of 1023 patients. Dis Colon Rectum 1994;27:593-7.

Parks AG. Pathogenesis and treatment of fistula in ano. Med J

;1:463-9.

Parke AG, Stitz RW. The treatment of high fistula in ano. Dis

Colon Rectum 1976;19:487-99.

Bleir JI, Mollo H. Ligation of inter sphincteric fistula tract an

effective new technique for complex fistulas. Dis Colon Rectum

;53:43-6.

Herrichesen S, Christensen J. Incidence of fistula in ano

complicating ano rectal sepsis prospective study. Br J Surg

;73:371-2.

Fazio VW, James MC. Current Therapy in Colon and Rectal Surgery.

th ed., Vol.23. Basungstoke UK: Edward Arnold; 2005. p.445-8.

El-Sebal OI, El-Sisy AA. Comparative study between internal

sphincterectomy and sentinel pile, anal fissure. Manual Med J

;27:419-22.

Lumnis PJ, Philiphs RK. Anal Fistula; Evaluations and

Management Specialist Surgical Practice Colorectal Surgery.

th ed., Vol. 14. London, UK: Hospital and Academic Institute,

Elsevier; 2014. p. 215-7.

Sheikh IA, Shukr I, Hanifi MS. Fistulotomy v/s fistulae in the

treatment of simple low anal fistula of male patients pal armed

forces. Med J 2015;656:798-802.

Kirk RM. General Surgical Operations. 4thed. Edinburg: Churchill

Living Stone; 2000. p. 361-3.

Degue CK, Desouza SM. Faecal in continence as consequences

of an rectal surgeries and the physiotherapeutic approach.

J Coloproct 2011;31:248-56.

Koshinberg O. To lay open or incise a fistula in ano randomized

trial. Br J Surg 1985;72:970-3.

Published
2021-12-13
Section
Articles