MANAGEMENT OF DEEP POST ANAL SPACE SUPPURATION ASSOCIATED WITH HORSESHOE FISTULA: CONVENTIONAL LAY OPEN METHOD VERSUS POSTERIOR MIDLINE APPROACH | ||||
| The Egyptian Journal of Surgery | ||||
| Volume 31, Issue 4, October 2012, Page 155-160 PDF (624.96 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/ejsur.2012.367250 | ||||
 View on SCiNiTO | ||||
| Authors | ||||
| Walid Abd El Maksoud* ; Mohamed Mazloum Osman; Yousry Gaweesh | ||||
| Department of General Surgery, Faculty of Medicine, University of Alexandria, Egypt | ||||
| Abstract | ||||
| Aim: The aim of this study was to evaluate treatment of anal fistulae with deep post anal space affection using posterior midline approach compared to the conventional lay open method using the lateral approach. Methods: Sixty patients with complex horseshoe fistulas of cryptoglandular origin, diagnosed by clinical examination and preoperative MRI were randomly allocated into 2 groups. Group A were subjected to the conventional lay open method while group B patients were subjected to the posterior midline approach. After the surgery the patients were followed up for a period of one year noting the healing time, effect on continence, and the occurrence of recurrence. Results: The mean healing time for group A was shorter than of group B. Patients of group B showed significant less time to regain their normal activity. Overall patients experienced little or no effect on the continence mechanism compared with their situation before surgery with slightly better results in the group B patients. The recurrence rate was 13.3% % for group A compared to 3.3% for group B with no statistical significance. Conclusion: The posterior midline approach is a good surgical approach for treating complex and horseshoe fistulas giving good results as regard healing time, effect on continence, and recurrence. | ||||
| Keywords | ||||
| Anal fistula; space of Courtney; Hanley's technique | ||||
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