부산대학교 도서관

Background: An anal fistula is a pathological connection between the anal canal and perianal tissue, typically developing from an infected anal crypt. Regarding its surgical management, controversy persists regarding whether a fistulectomy should be performed instead of a fistulotomy in the case of a low-lying simple anal fistula. Hence, we compared fistulotomy and fistulectomy in managing low anal fistulas. Methods: In this prospective comparative study, 90 patients aged >18 with a low-lying anal fistula were included. Out of 90 patients, 45 underwent fistulectomy, and 45 underwent fistulotomy as the treatment for low anal fistula and were followed up for three months. Mean operative time, healing time, flatus incontinence, and pain (on a visual analog scale) were compared. Results: The mean age of the patients was 39.66±10.80 years, with male dominance (86.7%) in both groups. The mean operative time of patients of the fistulectomy group (35.31±7.48 min) was significantly longer (P=0.005) than that of the fistulotomy group (31.33±5.39 min). In the fistulectomy group, the mean healing time was significantly higher (28.69±4.56 days) as compared to the fistulotomy group (24.87±4.79 days) (P<0.001). The pain score was significantly higher in the fistulectomy group than in the fistulotomy group (P<0.001). However, flatus incontinence was similar between the groups (P>0.05). There were no cases of recurrence in either group. Conclusion: Our study indicates that fistulotomy is a better option for managing low anal fistulas due to a shorter operative time, earlier healing, and fewer complications. [ABSTRACT FROM AUTHOR]