Long-term Outcomes After Anal Fistula Surgery: Results From Two University Hospitals in Thailand.

Annals of Coloproctology
Weeraput ChadbunchachaiKrisada Paonariang

Abstract

This study aimed to evaluate long-term outcomes after anal fistula surgery from university hospitals in Thailand. A prospectively collected database of patients with cryptoglandular anal fistula undergoing surgery from 2011 to 2017 in 2 university hospitals was reviewed. Outcomes were treatment failure (persistent or recurrent fistula), fecal continence status, and chronic postsurgical pain. This study included 247 patients; 178 (72.1%) with new anal fistula and 69 (27.9%) with recurrent fistula. One hundred twenty-one patients (49.0%) had complex fistula; 53 semi-horseshoe (21.5%), 41 high transsphincteric (16.6%), 24 horseshoe (9.7%), and 3 suprasphincteric (1.2%). Ligation of intersphincteric fistula tract (LIFT) was the most common operation performed (n=88, 35.6%) followed by fistulotomy (n=79, 32.0%). With a median follow-up of 23 months (interquartile range, 12-45 months), there were 18 persistent fistulas (7.3%) and 33 recurrent fistulae (13.4%)-accounting for 20.6% overall failure. All recurrence occurred within 24 months postoperatively. Complex fistula was the only significant predictor for recurrent fistula with a hazard ratio of 4.81 (95% confidence interval, 1.82-12.71). There was no significant difference in heal...Continue Reading

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