A Retrospective Study of Fistula in Ano & Primary Sphincter Repair (Sphincteroplasty) in Complex Fistulas

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dc.contributor.authorSambasivudu, Chanduen_US
dc.contributor.authorVineela, Chanduen_US
dc.date.accessioned2020-11-18T10:18:12Z
dc.date.available2020-11-18T10:18:12Z
dc.date.issued2020-04
dc.description.abstractFistula in ano is a common perianal disease of the mankind. It is secondary to mainly cryptoglandular infections & abscess. Persistence of chronic infection will lead to fistula formation.1 Management of high-level fistulas is complicated due to incontinence, which is troublesome; hence, many procedures have been tried by many surgeons, but without any supremacy over others. Immediate reconstruction of divided sphincter muscle will give good result.2 We have done fistulectomy & repair of the external anal sphincter & followed for the last two decades with no incontinence & minimal recurrences.METHODS192 cases of fistula in ano for the last 20 years operated by a single surgeon (1st author) were studied & were followed up to now. The differences, in the selection of cases, surgical skill & post-operative management are excluded in the study by including cases done by a single surgeon (first author) only. 136 males & 56 females were operated. Intersphincteric 45.8%, trans-sphincteric 49%, high level fistulas 5.2%, trans-sphincteric & high fistulas with considerable external sphincter loss (54 cases) were repaired with 1–0 Vicryl. Fistula in ano is associated with haemorrhoids in 24/192 & ano rectal abscess (20/192). Fistulotomy done in 16/192, simple & subcutaneous tracts - fistulectomy done in 65%. Curetting of the high tracts done in 16/192.RESULTSMales are predominantly affected 70.8%. This is more common in 3rd, 4th & 5th decades (80.1%). Single external opening was seen in (90%). Posterior & lateral fistula tracts are more commonly seen in (89.6%). Non-specific pyogenic infective pathology is seen 99%. Recurrences- 6/192. Time taken to heal is 3–6 weeks. Incontinence is not seen in any case. No recurrence or incontinence seen in primary sphincter repair of 54 cases.CONCLUSIONSPrimary sphincter repair is simple & best procedure with minimal or no recurrence & decreases the healing time. It is more suitable & advised in fistulas with considerable external sphincter loss.en_US
dc.identifier.affiliationsDepartment of General Surgery, NRI Medical College, Sri Venkateswara Nursing Home, Tenali, Andhra Pradesh, Indiaen_US
dc.identifier.affiliationsDepartment of General Medicine, NRI Medical College, Sri Venkateswara Nursing Home, Tenali, Andhra Pradesh, India.en_US
dc.identifier.citationSambasivudu Chandu, Vineela Chandu. A Retrospective Study of Fistula in Ano & Primary Sphincter Repair (Sphincteroplasty) in Complex Fistulas. Journal of Evolution of Medical and Dental Sciences. 2020 Apr; 9(14): 1126-1130en_US
dc.identifier.issn2278-4802
dc.identifier.issn2278-4748
dc.identifier.placeIndiaen_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/214798
dc.languageenen_US
dc.publisherAkshantala Enterprises Private Limiteden_US
dc.relation.issuenumber14en_US
dc.relation.volume9en_US
dc.source.urihttps://dx.doi.org//10.14260/jemds/2020/244en_US
dc.subjectFistula in Anoen_US
dc.subjectExternal Anal Sphincteren_US
dc.subjectAbscessen_US
dc.subjectSphincter Repairen_US
dc.subjectFistulotomyen_US
dc.subjectFistulectomyen_US
dc.subjectAnal Glanden_US
dc.subjectIncontinenceen_US
dc.subjectHaemorrhoids & Recurrenceen_US
dc.titleA Retrospective Study of Fistula in Ano & Primary Sphincter Repair (Sphincteroplasty) in Complex Fistulasen_US
dc.typeJournal Articleen_US
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