Clinical study of fistula in ano in patients attending surgical OPDs of a tertiary care teaching hospital, Central India

Abstract

Background: A fistula-in-ano is an abnormal hollow tract or cavity that is lined with granulation tissue and that connects a primary opening inside the anal canal to a secondary opening in the perianal skin; secondary tracts may be multiple and can extend from the same primary opening.Methods: All cases of clinically diagnosed fistulae-in-ano admitted in various surgical units in Index Medical College Hospital, Indore during the study period January 1, 2015 to December 31, 2017. A Preformed set of questionnaires will be prepared and tested and the same proforma will be used for the study of selected clinically diagnosed cases of Fistula-in-ano. Clinical history was obtained in all the patients. Clinical examination including per rectal and proctoscopic was done in required patients.Results: Total 44 cases of fistula in ano were selected randomly using closed envelope method and studied in detail the following results were obtained. In this present series, 56.81% of patients were in the age group of 31-60 years followed by 34.09% of patients were in the age group of 11-30 years. Only 9.09% of patients were in the age group above 60 years. About major clinical features were noted perianal discharge, pain, swelling and peri anal irritation were 75%, 65.91%, 43.18% and 11.36% respectively.Conclusions: Early diagnosis and appropriate management is the key to success. Fistula-in-ano forms a good majority of treatable benign lesions of rectum and anal canal. 90%or so of these cases are end results of cryptoglandular infections.

Clinical study of fistula in ano with special reference to its surgical management

“…16 Also in current study, perineum discharge was the commonest symptom in all cases (100%) and which was either continuous or intermittent in nature as similar to the previous studies. 1,[17][18][19][20][21] Almost all cases had one opening either on one side of midline to right or left and anterior or posterior to the anal opening. Only two cases had 2 openings each in this present series.…”

A PILOT STUDY on the Clinical and Functional Outcomes of an Improvised Technique of Core-cut Fistulectomy for Fistula-in-ano

“…15 Qureshi et al reported 80% posterior fistula and 20% anterior fistula. 13 Yadu S et al reported 76% posteriorly located fistula. 14 In a study by Kumar HM et al, 66% were posterior fistulae, 24% anterior, and 10% lateral fistulae.…”

“…12 Qureshi et al reported discharge in 75% of patients. 13 Yadu S et al reported discharge in 74% of patients. 14 Our study reports are like those previously reported, the absence of discharge could suggest a quiescent nature of the fistula which is possibly a part of the course of the disease.…”

“…5 Newer techniques like fibrin glue, Ligation of Inter-sphincteric Fistula Tract (LIFT), Bio-LIFT, Submucosal Ligation of Fistula tract (SLOFT), Fistula-tract Laser Closure (FiLAC), Video Assisted Anal Fistula Treatment (VAAFT), Fixcision (core-cut), Mucosal advancement flap, and Fistula plug, as well as hybrid procedures using more than one of the above are emerging as sphincter-saving procedures. [6][7][8][9][10][11][12][13][14] Recently, adipose tissue stem cell therapy for anal fistula has also been described. 15 The main disadvantage of the older conventional techniques is their inconsistent results, relatively higher failure rates, and incidence of fecal incontinence.…”