Comparison of Various Techniques for Management of Fistula-In-Ano

Indian Journal of Applied Basic Medical Sciences
Year: 2020, Volume: 22(A), Issue. (1)
First page: (111) Last page: (117)
Online ISSN: 2249-7935
Print ISSN: 0975-8917
doi:10.48165/ijabms.2020.22110

Comparison of Various Techniques for Management of Fistula-In-Ano
Yogesh kumar N. Modiya1, Jainam K. Shah2,Meet Dadga3,Harsh Patel4,Yash Vyas5,Kush Mehta6
1M.S. General Surgery, FIAGES Assistant professor of general surgery, 2M.S. General Surgery,  FMAS, FISCP Associate professor of general surgery, 3R3, 4 R3, 5 R1 ,6 R1  Department of surgery SVP Hospital & NHL Medical college , Ellis bridge, Ahmedabad Pin  380008  
Corresponding author email id:

Online Published on 02-Jan-2020

ABSTRACT

Background: Definition – A fistula-in-ano or Anal fistula is a chronic abnormal communication, usually lined  by granulation tissue, which runs outwards from anorectal lumen (internal opening) to external  opening on the skin of perineum or buttock (or rarely, in women, to the vagina). Fistula in ano  most commonly follows an anorectal sepsis[1]. The basic principles of management of anal fistula are closure of internal opening of fistula  tract, drainage of infection or necrotic tissue, and eradication of fistulous tract with  preservation of sphincter function. The objectives were to compare the various aspects like per operative complications, post operative complications, mean hospital stay in the treatment of fistula in ano using various  modalities like fistulotomy, fistulectomy, setons and lift procedure. Methods:This is a randomised, comparative, prospective study of 40 cases of fistula in ano,  presenting at surgical opd of V.S.Hospital, Ahmedabad attached to NHL Medical College. Out of  which, 10 cases are treated by fistulectomy, 10 by seton, 10 by fistulotomy and the rest 10  cases by LIFT procedure by random selection method, during period of NOVEMBER 1, 2017 to  31st October 2018. Results:Most common age of presentation is 31-40 years and more common in males then  females (M:F= 2.3:1 ). Per operative complications include bleeding seen more in patients  undergoing fistulectomy. Per operative course of LIFT procedure patients was complication  free. Postoperative pain seen more in patients undergoing setons procedure. Conclusions:we conclude that LIFT procedure and Fistulotomy were acceptable procedures for  simple, uncomplicated low lying and high lying fistula.

Keywords

Fistulotomy, Fistulectomy, LIFT procedure, Setons