A Prospective and Comparative Study on Fistulotomy with Sphincteroplasty or Fistulotomy without Sphincheteroplasty of Partially Damaged Internal Sphincter and Assessment of Incontinence, Recurrence and Patient Satisfaction in the Patient of High Fistula-in-Ano

Abstract

Hiteshawari Baghel, Arvind Ghanghoria, Shubham Gupta, Lavanya Kelum, Prakhar Chaudhary and Samprati Dariya

Introduction: Surgery is the only mainstay treatment for fistula-in-ano. Fistula-in-ano is known to human for more than 2000 years, but still the surgical treatment remains challenging, due to differences in success, reoccurrence rates and incontinence risks. Till date, fistulotomy procedures is known as the gold standered surgical treatment, with a perfect surgical field view and allowing direct access to the source of inflammation The aim of this prospective study is to evaluate the safety and long-term efficacy of Fistulotomy with end to end primary sphincteroplasty and to assess its impact on patients’ postoperative continence status, recurrence, wound and satisfaction. Materials and methods: N=35 in both the groups (Fistulotomy with sphincteroplasty group and Fistulotomy without sphincteroplasty group) inclusion criteria the patients who of fistula-in-ano with probable etiology of cryptoglandular theory. Result and discussion: Incontinence was seen in 9 (25.7%) patients in fistulotomy group and 2 (5.7%) patients in fistulotomy with sphincterotomy group. Recurrence was seen in 12 (34.3%) patients in fistulotomy group and 4 (11.4%) patients in fistulotomy with sphincterotomy group. Wound infection was seen in 16 (45.7%) patients in fistulotomy group and 7 (20%) patients in fistulotomy with sphincterotomy group. The mean satisfaction score in fistulotomy group was 7.06 ± 0.54 and in fistulotomy with sphincterotomy group was 8.26 ± 0.61. Conclusion: The total outcomes for the patient with fistula-in-ano, which have undergone fistulotomy with sphincteroplasty, the outcomes are much better in terms of recurrence, incontinence; post op wound infection and patient satisfaction.