Comparative Study of Fistulectomy and Fistulotomy in the Management of Fistula-in-ano
Journal Title: New Indian Journal of Surgery - Year 2019, Vol 10, Issue 4
Abstract
Context: Fistula-in-ano is a condition that has been described virtually from the beginning of medical history. A fistula is usually the result of a previous crypt abscess or glandular infection in the area which has been drained inadequately and not fully healed. This results in persistent or intermittent discharge of pus, blood or mucus. There is not usually much pain, although an abscess can sometimes recur. Fistulotomy is one of the common surgical procedures wherein a probe is passed through the entire fistulous track, incision is made over the probe to cut and lay open the fistulous track. In Fistulectomy, a probe is passed through external opening up to the internal opening, fistula is opened along the probe using a knife, and fibrous tract along with unhealthy granulation tissue is excised. The aim of the study is to compare the operation time, postoperative wound size, postoperative pain, recurrence, anal incontinence and quality of life in both the groups. Materials and Methods: This comparative study was conducted from 2017 to 2018 that was conducted on 60 consecutive patients diagnosed to have low fistula-in-ano. 30 patients underwent fistulotomy and 30 patients underwent fistulectomy. Parameters related to surgery, postoperative period and follow up were observed, tabulated and analyzed. Results: Mean operative time was (11.63 mins) in fistulotomy when compared to fistulectomy which was (12.17 mins). Postoperative wound size was (2.51 cms) in fistulotomy when compared to fistulectomy (2.80 cms). Postoperative pain on day 1 and on day 3 was less in fistulotomy compared to fistulectomy. The quality of life was better following fistulectomy compared to fistulotomy due to more rate of recurrence in fistulotomy group. Conclusions: Fistulectomy can be considered a better procedure for a low anal fistula owing to lesser postoperative recurrence.
Authors and Affiliations
Bijaya Kumar Sethi
Keywords
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- EP ID EP671665
- DOI 10.21088/nijs.0976.4747.10419.10
- Views 103
- Downloads 0
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