Is Fistulotomy a Better Option Than Fistulectomy For Low Anal Fistulae?

Ainul Hadi, Imranuddin Khan, Muhammed Zeb, Shahidullah, Shehzad Akbar Khan

Abstract

Abstract:

Objective:

To compare the postoperative results of fistulectomy and fistulotomy for low fistula in ano.

Study Design::

Comparative study.

Place and duration of study::

Surgical ‘B’ unit, Hayatabad Medical Complex Peshawar, from March 2020 to February 2021.

Methodology::

In this comparative study, a total of 48 patients were included. They were divided into groups A and B, each comprising of 24 patients. After thorough investigations, group A was subjected to fistulectomy and group B to fistulotomy. Patients were followed in OPD for 12 weeks. Postoperative outcomes were recorded and analyzed through SPSS version 16. The Chi-Square test was used for the comparison of categorical data. A p < 0.05 was taken as statistically significant.

Results: 

Age of the subjects was from 23 years to 65 years with a mean age of 37.5±6.5 years. Male to female ratio was 7:1. Preoperatively, 81.25% patients had subcutaneous, 12.5% intersphincteric and 6.25% transphincteric low anal fistulae. Postoperative morbidity included pain (group A - 75% and group B - 41.7%), discharge from wound (group A - 50% and group B - 37.5%), and recurrence rate of fistula 8.3% in group A and 4.2% in group B. Operative time was 30 to 40 minutes in group A and 15 to 25 minutes in group B (p=0.04), wound healing time 6 to 8 weeks in group A and 4 to 6 weeks in group B (p=0.04). However, the hospital stay was 1 to 2 days in both the groups which was insignificant (p=1.00).

Conclusion:

Fistulotomy procedure was found better in terms of postoperative outcome compared to fistulectomy.

Key words: 

Fistulotomy, Fistulectomy, Low fistula in ano.