Multifactorial Analysis of Postoperative Recurrence of Anal Fistula: A Retrospective Study.

Abstract

Background: The aim of this study is to investigate the main factors that influence the recurrence of anal fistulas in patients with perianal abscesses following incision and drainage treatment.

Methods: A retrospective case-control study was performed according to the STROBE guidelines for patients with perianal abscesses who underwent surgical treatment at Guangdong Provincial Hospital of Chinese Medicine in Zhuhai and at the Affiliated Hospital of Xuzhou Medical University in Lasso between June 2021 and June 2023. Lasso and multivariate logistic regression analyses were performed to further determine the recurrence of perianal abscesses.

Results: A total of 435 patients were included in the study, with a median follow-up period of 25 months (range 18-40 months) after receiving treatment for perianal abscesses. Of these patients, 27 were in the anal fistula group and 408 were in the cured group. The results of the multivariate logistic regression analysis showed that a history of abscesses, enteritis, intraoperative pus cavity residue, standardized dressing changes after discharge, the surgeon's specialty, preoperative ultrasound or MRI examination, Parks classification and Wexner score were independently influential factors in the formation of anal fistulas after perianal abscess surgery (P < 0.05).

Conclusion: A history of abscesses and enteritis, Parks classification, and intraoperative pus cavity residue are high-risk factors for anal fistula recurrence. Standardized dressing changes after discharge, a preoperative ultrasound or MRI scan, and a postoperative assessment of anal function (Wexner score) are important for protecting anal sphincter function and improving the prognosis of perianal abscesses.