Faisal Shabbir, Ansar Latif, Fayyaz Ahmad Orfi, Tatheer Fatima, Muhammad Ahmad, Anila Ansar.
Surgery for Fistula in Ano-is it aDisappointment for Surgeons?.
Pak J Med Health Sci Jan ;13(1):20-1.

Aim: To analyze the outcome of surgical treatment of perianal fistula in patients admitted to the surgical department in Allama Iqbal Memorial Teaching Hospital, Sialkot, Pakistan. Study Design: Prospective study. Setting and duration of study: Department of Surgery, Khawaja Muhammad Safdar Medical College, Sialkot; from December 2015 to April 2018. Methods: Patients presenting in surgical out patients department with perianal fistulawere serially enrolled. Data of 150patients was collected from December 2015 to April 2018. Two groups were made; Group I- primary cases and Group II- Recurrent Fistula. Outcome of surgery was analysed after regular follow up. Only those patients’ data was collected and analysed with follow up of at least three months after surgery. Results were analysed using SPSS v22. Results: Out of 150 patients included in our study, the mean age was 40 years: the majority of the patients were males. The average duration of hospitalization was 2.5 days. The average time to return towork was 5+/- 2.0days in recurrent fistulas as compared to 3 +/- 1.0days in primary cases. No serious complications were encountered, and preoperative complaints recurred only in 14 patients in primary group-I while there were 7 patients of recurrent group who had recurrence for the second time. Details of surgical proceduresis , Fistulotomy was done in 31% patients of Group I and 24% of Group II while fistulectomy was done in 65% of Group I and 42% of Group II patients, Seton placement was a procedure done in 2% Patients in Group I and 27% patients in recurrent cases, 0.3% patients of Group I and 1.6% pateints of Group II were undergone mucosal advancement flap techniques and Colostomy and fistulectomy were done in 0.6% patients of Group I and 3% patients of Group II. Conclusion: Surgery for perianal fistula is something not liked by the surgeons due to associated morbidity especially recurrence. Recurrent fistulas are more resistant to healing; however primary surgical treatment offers the best chance of cure.

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