[Surgical treatment of anorectal fistulas. A 17-year experience at the Instituto Nacional de la Nutrición "Salvador Zubirán"].

INTRODUCTION

Surgical treatment for anorectal fistula may be difficult because of the risk of recurrence, prolonged healing or anal incontinence following the operation.

OBJECTIVE

To analyze the experience with the surgical management of ano-rectal fistula during a period of 17 years.

PATIENTS AND

METHODS

The medical records of 105 patients with anorectal fistulas were reviewed retrospectively, with analysis of demographic and clinical data, operative treatment, and results.

RESULTS

There were 73% men and 27% women. Mean age was 45 years. 86% had an underlying chronic disease, most frequently diabetes mellitus (21%) and obesity (14%). No anatomic classification of the fistulous tract was done in 86% of cases, and inter-sphincteric tracts were the most frequent type in the classified cases. In 90% of cases, treatment was fistulectomy. Complications occurred in 13% of cases, mainly delayed healing (6.5%). Recurrent disease was documented in 11 cases (10%), and the majority were treated with a new fistulectomy. There were no cases with anal incontinence following the operation.

CONCLUSIONS

The necessity of performing the anatomic classification of ano-rectal fistula should be emphasized. Fistulectomy was the most frequent surgical procedure.