SHOULD LOW ANAL FISTULA BE TREATED WITH FISTULOTOMY OR FISTULECTOMY?

Abstract

Background: There is a chronic abnormal communication between the anal canal, rectum, and perianal skin, lined by granulation tissue which is known as an anal fistula. The occurrence of anal fistula and abscess formation is rare, like 1-2 over 10,000.  This disease mostly affects adults who are aged between 20 to 45 years. According to their association with the anal sphincter, anal fistulae are categorized into a number of categories such as complex, simple, Trans sphincteric, extra sphincteric, supra sphincteric, intersphincteric, high or low.

Objective: This study's objective was to contrast the postoperative results of fistulotomy and fistulectomy in patients with low fistula-in-ano.

Study design: A comparative study

Place and Duration This study was conducted in Peoples University of medical and Health sciences for women Nawabshah from April 2022 to April 2023

Methodology: All of the participants were diagnosed with low fistula-in-ano and were admitted to the outpatient department. The sample size was equally divided into 2 groups, consisting of 25 patients in each group. People in group A were treated with fistulectomy and people in group B were treated with fistulotomy. Low Trans sphincteric, subcutaneous, and low intersphincteric are the types that are included in low fistula-in-ano. Every patient’s clinical history was obtained. A proper clinical examination was conducted on the participants which included a digital rectal examination (DRE). It was conducted to examine the tone of the anal sphincter.

Results: There were a total of 50 people enrolled in this research. They all were divided into 2 groups. Most participants were men, representing 88% of the total sample size. There were a total of 44 men and only 6 women, showing a ratio of 7.3:1. The average age of the participants was 37.5 years. A total of 82% of the participants were having subcutaneous anal fistula. Fistulotomy took less time to operate as well as wound healing.

Conclusion: fistulotomy for low-type anal fistula resulted in superior postoperative results, including greater pain reduction, earlier hospital discharge, and faster wound healing.