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. 2003 Nov;5(6):549-51.
doi: 10.1046/j.1463-1318.2003.00459.x.

Anal fistulotomy between Skylla and Charybdis

M Westerterp  1 , N A Volkers, R W Poolman, W F van Tets
Affiliations

Anal fistulotomy between Skylla and Charybdis

M Westerterp et al. Colorectal Dis. 2003 Nov.

Abstract

Objective: This study was undertaken to assess the results of anal fistulotomy on faecal continence, recurrence and satisfaction.

Methods: We reviewed the records of 60 patients who underwent anal fistulotomy between 1997 and 2000. Follow-up was by a questionnaire with 46 (77%) patients responding. Mean follow-up was 1-4 years. Fistulas were intersphincteric in 12 patients and transsphincteric in 34 patients. Operative procedure consisted of fistulotomy.

Results: Of 11 patients with high fistula, 9 (82%) had impaired continence; Of 17 patients with midanal fistula, 4 (24%) suffered impaired continence. Eighteen patients had a low fistula and 8 (44%) developed impaired continence. In the whole group 50% had suffered faecal incontinence. There were no recurrences and there was satisfaction with the situation in 87% of patients.

Conclusions: Fistulotomy for primary fistula in ano in this retrospective study with a follow-up up to 4 years was associated with no recurrences. Eighty-two percent of patients with a high anal opening have impaired faecal continence, nevertheless patients' satisfaction is high.

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