Fistulotomy versus fistulectomy in the treatment of low fistula in ano

Abstract

Objectives To evaluate the outcome of the fistulotomy and fistulectomy for the treatment of Low type Fistula in ano. Patients and Methods This analytical study was carried out at Surgical Unit II of Chandka Medical College Teaching Hospital, Larkana, from January 1, 2010 to December 31, 2010. The study included 50 patients of low type Fistula in ano admitted during study period. Out of these, 25 patients were operated by fistulotomy (Group A) and 25 by fistulectomy (Group B). Pain and bleeding were noted. All the patients were followed up weekly till complete wound healing was observed, then monthly up to six months post operatively. Results Three patients of group A (12%) complained of pain postoperatively on first post operative day, while complaint of postoperative pain was noted in 7 patients of group B (28%). Postoperative bleeding was seen in 1 patients (04%) in group A, whereas it was seen in 3 patients (12%) of group B. None complained of incontinence either to flatus or feces; nor was recurrence seen in either group. The post operative hospital stay period in group A ranged between 1 to 4 days, with a median period of 1.5 days, and that in group B was 1 to 6 days, with median period of 2.5 days. The average healing time in patients in Group A was 24 days (range 18- 30 days); while that in patients in Group B was 35 days (range 28- 42 days). Conclusions Fistulotomy resulted in lesser pain, bleeding, lower hospital stay and early wound healing and better patient compliance. (Rawal Med J 2011;36:284-286 ).