A Comparative Study between Fistulectomy and Fistulotomy with Marsupialization in Management of Simple low Anal Fistula

Document Type : Original Article

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Department of General Surgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

Abstract

Background: A fistula in ano is an opening lined by granulation tissue that extends from the deep anal canal or rectum to the superficial epidermis of the anus. Fistulotomy is considered the gold standard treatment.
The Aim of the work: This work aimed to compare fistulectomy and fistulotomy with marsupialization in uncomplicated low anal fistula.
Patients and Methods: Sixty [60] individuals with uncomplicated perianal fistula were enrolled in this prospective study. Patients were enrolled from the surgical clinics of El Hussein University Hospital and Fayoum insurance hospital. Complete medical history, physical examinations were done for every patient at the time of enrollment and before the surgical intervention.
Results: According to the types of fistulae, inter-sphincteric type was the most common type with no significant difference between the 2 groups [P value = 0.8]. As regards the wound healing time, it was shorter in group B than in group A [P value = 0.001].  In terms of the postoperative complications, Urinary retention, bleeding, infection, and incontinence were the most reported complications, with an overall complication was higher in group A than in group B.
Conclusion: Faster recovery and shorter wound discharge time are the results of a fistulotomy with marsupialization as opposed to a fistulectomy. For simple perianal fistulas, fistulotomy with marsupialization is an effective alternative to fistulectomy.

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