Coring and ligation of the external anal fistula tract : a cross-sectional study

Abstract

Purpose: Fistula-in-ano is a benign anorectal disease which always poses a big dilemma to the surgeons because of their significant recurrent rate and longer healing duration following surgery. We report our experience with fistulectomy surgeries in our center. Materials and Methods: A cross-sectional study to review the patients that underwent fistula surgery has been made in the Hospital Tengku Ampuan Afzan, Kuantan, Pahang. A total of 43 patients underwent fistulectomy under elective operation list identified. Demographic data of patients were assessed. Patient subjected to endoanal ultrasound prior to the surgery to determine types of fistula based on Park’s classification. Follow up was made post-operatively in a scheduled timing to see the progress, duration of healing, and recurrence or persistent of the disease. The follow up timings were at 4th weeks, 2nd month, 3rd month, 4th month, 5th month and 6th month. Results: Mean age of the patient presented to our center was 38.4 years old. Intersphincteric and transphincteric type of fistula account 40.5% and 54.8% respectively. 54.8% of patients achieved primary healing after the procedure. Mean healing duration of those who underwent core fistulectomy is 3.7 months. 33.3% of patients subjected to core fistulectomy failed to fully recover either had persistent or recurrence of the disease. Conclusions: Even though we managed to achieve significant success rate cumulatively, persistent or disease recurrence still imposed the challenge toward patient’s management of the disease in a long run. Therefore, further prospective study is recommended to look into this method in term of rapid recovery with minimal morbidity.