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Year : 2018  |  Volume : 1  |  Issue : 2  |  Page : 43-47

Recurrence rates and fecal incontinence after fistulotomy or fistulectomy

Poona Hospital and Research Centre, Pune, Maharashtra, India

Correspondence Address:
Deepak Phalgune
18/27, Bharat Kunj - 1, Erandawane, Pune - 411 038, Maharashtra
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/IJCS.IJCS_13_18

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Background: In spite of the availability of various treatments for fistula-in-ano, consensus cannot be reached as to the best form of treatment with regards to recurrence and incontinence. Fistulotomy and fistulectomy remain the two most commonly practiced surgeries. The study was undertaken to compare the recurrence rates and fecal incontinence in patients undergoing fistulotomy or fistulectomy. Materials and Methods: Hundred and ten patients with primary or recurrent fistula-in-ano of low anal type were included. Fistulectomy and fistulotomy were performed in 53 and 57 patients, respectively. The final follow-up at 6 months postoperative was done to assess any recurrence. The patients were required to fill Wexner's questionnaire at the monthly follow-up to monitor incontinence. Statistical significance of the difference of categorical and continuous variables was tested using the Chi-square test and unpaired t-test, respectively. Paired t-test was used for intra-group comparison. Results: At 6th month follow-up, Wexner's score was normal in 49/53 (92.5%) and 52/57 (91.2%) fistulectomy and fistulotomy patients, respectively, which was not statistically significant (P = 0.564). Mean Wexner's score at 6 months follow-up was significantly less as compared to 1st week follow-up in both fistulotomy and fistulectomy groups. Recurrence rate was 5/57 (9.4%) and 7/53 (12.3%) in fistulectomy and fistulotomy patients, respectively, at 6 months follow-up which was not statistically significant (P = 0.763). Conclusion: Fistulotomy and fistulectomy are equally effective in the treatment of low anal fistulas with acceptable rates of recurrence and fecal incontinence at 6 months follow-up after surgery.

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