COMPLEX ANAL FISTULA: CLINICO-PATHOLOGICAL VARIABLES AFFECTING CURE | ||||
| The Egyptian Journal of Surgery | ||||
| Volume 32, Issue 2, April 2013, Page 121-126 PDF (267.68 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/ejsur.2013.366745 | ||||
 View on SCiNiTO | ||||
| Authors | ||||
| Mohamed Mazloum Osman; Walid Abd El Maksoud* ; Yasser Zaki; Ahmed Moaz | ||||
| General Surgery Department, Faculty of Medicine, University of Alexandria, Egypt | ||||
| Abstract | ||||
| Aim: The aim of this study was to evaluate different clinic-pathological variables affecting outcome of surgical management of complex anal fistulas in terms of recurrence and anal incontinence. Methods: Ninety six patients with complex anal fistulae were included in this study. Fistulotomy operation was done for eighty two patients (85.4%). Fourteen patients (14.6%) with high anal fistulas were operated by two stages Seton technique. Post-operative recurrence and incontinence, as outcomes, were detected by the surgeon in outpatient clinic. Analysis of demographic, clinical and pathological criteria of these patients was done to determine factors affecting these outcomes. Results: Recurrence occurred in eleven patients (11.5%), while minor incontinence was found in fifteen patients (15.6%). Surgical management of complex anal fistulas with multiple external openings showed significant increase in the incidence of recurrence, incontinence, and delayed wound healing. Female gender and older age showed significant relation with incontinence. Conclusion: Female gender, older age and fistulas with multiple external openings are associated with increasing risk of recurrence, incontinence, and delayed wound healing. Sound understanding of the anatomy of the fistulous tract and its relation to anal sphincter in addition to factors affecting outcomes is a must for proper planning for surgical management of complex anal fistula. | ||||
| Keywords | ||||
| Complex anal fistula; Recurrence; Anal incontinence | ||||
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