[Abscess excision and primary fistulectomy as initial therapy of peri-proctal abscess. A prospective analysis of 122 patients].

A prospective study of 122 patients with anorectal abscesses was carried out to elucidate the value of abscess drainage with primary fistulectomy, when fistulas were identified. Patients were followed from 2 1/2 to 3 1/2 years with a mean follow-up of three years. In 52 patients (Group A) a primary fistula was present (42.6%), in 47 patients simultaneous excision of abscess and drainage of the intersphincteric space combined with partial sphincterotomy was performed. Recidives occurred in 17.3%. In 5 patients with a high transsphincteric or suprasphincteric fistula, a two-stage fistulectomy was done. In all 70 patients of group B no fistula was found at drainage operation. The incidence of recurrent anorectal abscess was 21.4%. In this group it is shown that the rate of recurrence was not related to a simultaneous excision of abscess and drainage of the intersphincteric space.