Types of Fistula in Ano and Postoperative Outcomes at Maharat Nakhon Ratchasima Hospital
Keywords:fistula in ano, type of fistula, recurrence
AbstractBackground: A fistula in ano is an abnormal tract or cavity communicating with the rectum or anal canal by
identifiable internal opening. Recurrent rates after treatment may approach 25%.
Objective: To assess the relative prevalence of each type of fistula in ano, describe intraoperative findings and
determine recurrence rate.
Patients and methods: Fistula in ano patients who underwent operation from 1 January 2009 to 31 July 2010 at
Maharat Nakhon Ratchasima Hospital were prospectively studied.
Results: There were 120 patients (101 men, 19 women), aged between 2 to 87 years (mean age 42.4 years). Fistulain-
ano was simple in 84 patients (70%) and complex in 36 patients (30%). Among the complex fistula in ano patients
were those with high transphincteric fistula in 9 cases (25%), extrasphincteric in 1 case (2.8%), anterior fistula in the
female in 7 cases (19.4%), coexistent with inflammatory bowel disease in 5 cases (13.9%), with multiple simultaneous
fistula in 10 cases (27.8%), and had prior sphincter surgeries or injuries in 4 cases (11.1%). Fistulotomy was done in
75 cases (62.5%), core out fistulectomy in 28 cases (23.3%), seton drainage in 16 cases (13.3%), advancement flap in
1 case (0.9%). Overall recurrence was 15% (18 cases). Recurrent rates were 41.7% (15 cases) in the complex fistula in
ano group and 3.6% (3 cases) in the simple fistula in ano group, which were significantly different (P <0.05).
Conclusion: Simple fistula in ano was found in 70% and complex fistula in 30% of patients. Overall recurrence
rate was 15%; for the complex fistula group the recurrence was 41.7%, which was significantly different from the simple
fistula group (3.6%).
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