Low lying fistula-in-ano - fistulotomy or fistulectomy
Keywords:Fistula-in-ano, Fistulectomy, fistulotomy
Background: Fistula-in-ano is very common benign anal condition in day to day surgical practice which is treatable. The treatment is challenging even for an experienced surgeons due to its chronic and recurring nature. There are various treatment modalities available for management of anal fistula. Our aim is to study the outcome of fistulotomy and fistulectomy in patients with simple low-lying fistula. Methods: A prospective Randomised clinical study was done on 55 patients, they were randomized into two groups of fistulotomy (n=25) and fistulectomy (n=30) in GSVM medical college over a period of two years. Aim of the study was to compare the operative time, healing time, treatment outcome, complications and recurrence rate. The results were analyzed using SPSS version 22 using tests like student’s t test and chi square test. Results: The mean operative time of fistulotomy was 18.3 minutes and that of fistulectomy was 34.2 minutes, which is statistically significant ( p-value =0.008).Duration of healing in fistulotomy group (11 days) compared to fistulectomy group (22 days), which is statistically significant (p<0.001).Incidence of incontinence in fistulotomy group observed in 2 cases and in fistulectomy group was observed in 3 cases , which is insignificant (p-value=.797)There was recurrence in one case in both the groups in six months of follow-up period. Conclusion: Fistulotomy is better for treating low fistula-in-ano in terms of high healing rate, shorter operating time, shorter healing time which ultimately reduces the hospital stay and incidence of complications is comparable in both the groups.
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