Fistulectomy and Primary Sphincteroplasty for Transsphincteric Fistula.

Abstract

Objective: To evaluate the results of patients treated with fistulectomy and primary sphincteroplasty for uncomplicated perianal fistula.

Study design: Observational study. Place and Duration of the Study: Medicana International Hospital affiliated with Atilim University, Faculty of Medicine, Ankara, Turkiye, from January 2020 to September 2023.

Methodology: In this study, patients who were operated on for perianal fistula between 2020 and 2023 were retrospectively examined. Data were obtained retrospectively. All patients underwent preoperative perianal MRI. Clinical notes were evaluated with the Cleveland Clinic Incontinence Score (CCIS) by physical examination. All patients were followed up on the first postoperative day, 1st week, 1st and 3rd postoperative months.

Results: A total of 44 patients who underwent fistulectomy with primary sphincteroplasty were included in the study. Twenty-six patients (59.1%) had a history of perianal abscesses. It was observed that 34 (77.3%) of the patients had posterior, 7 (15.9%) anterior, and 3 (6.8%) lateral fistulas. A total of 3 patients (6.8%) were observed to have minor worsening in their incontinence scores. There was no statistically significant difference between the preoperative and postoperative 3rd month Cleveland Clinic Incontinence Score values of the patients (CCIS mean 1.6 vs. 1.7, respectively, p >0.05). Recurrence was observed in 1 patient (2.3%) during follow-ups.

Conclusion: Fistulectomy with primary sphincteroplasty is an effective and reliable method to preserve anal continence and improve quality of life.

Key words: Fistulectomy, Sphincteroplasty, Perianal fistula, Continence, Perianal abscess.