Quality of life following surgery for recurrent fistula-in-ano

Abstract

Recurrent fistula-in-ano significantly affects the patients' QOL, and also, successful surgery results in significantly improved long-term QOL. This improvement shows the need for those patients with fistula-in-ano to be subjected to further surgery despite the possible risk of anal incontinence.

Quality of life following fistulotomy – short term follow‐up

“…In this study QOL significantly improved following fistulotomy, and returned to that of the general population when continence deterioration was small; similar results have been found using SF-36 for other benign anorectal conditions such as haemorrhoid surgery [32] and anal fissure [33]. Using a GI disease-specific QOL questionnaire, the GIQLI [34], a similar result has been found with patients undergoing surgery for recurrent fistula [35], suggesting that the benefits of successful surgery may outweigh the risks of reduced continence. When investigating QOL in anal fistula surgery is it important to assess both QOL and continence: continence should not be considered the sole assessment, or as a surrogate for QOL, as patients with a small reduction in continence may not have a reduced QOL.…”

Cryptoglandular anal fistula

“…Undoubtedly, such divergent results are explained by the heterogeneity of publications [3,18,19]. While incontinence may regress with time [2], and while the overall improvement in quality of life afforded by surgery can be of sufficient benefit to outweigh minor incontinence of gas or loose stool [29][30][31], the risk of incontinence remains the major problem with fistulotomy surgery [18,19].…”

S3 guidelines: cryptoglandular anal fistulas

“…Weiterhin sind bei der Auswertung der Arbeiten die höchst unterschiedlichen Nachuntersuchungsquoten zwischen 40 und 90 % zu berücksich-tigen [134,173,458]. Neben dem Fistelrezidiv mit der Notwendigkeit wiederholter Eingriffe beeinträchtigt insbesondere die Minderung der Kontinenzleistung die Zufriedenheit und die Lebensqualität [135,379]. Eine Aufarbeitung historischer Krankenunterlagen von Blumetti et al [45] [119].…”