Clinical study of fistula in ano with special reference to its surgical management


  • Sivaji Sankar Ghose Department of Surgery, Naval Hospital Powai, Mumbai, Maharashtra, India
  • Mili Das Chowdhury Department of Obstretics and Gynaecology, Naval Hospital Powai, Mumbai, Maharashtra, India
  • M. Y. Dharmamer Department of Anaesthesia, Naval Hospital Powai, Mumbai, Maharashtra, India



Fistula-in-ano, Fistulectomy, Fistula, Histopathology, Incontinence, Proctoscopy, Posterior, Recurrence


Background: The present study was undertaken to evaluate the results of “Lay open method” fistulectomy technique in treating fistula-in-ano in terms of relief of symptoms, healing of wound, recurrence rate and post-operative complications.

Methods: Total 45 cases with definite history of fistula and clinically diagnosed cases of fistula in ano selected for the study. A final diagnosis was made after proctoscopic examination under anaesthesia during operation and by histopathological examination after completion of operation.  In all the patients, lay open method fistulectomy was done. Post-operative period was closely monitored and all the cases were meticulously followed for a variable period of time.

Results: The common fistulas were low anal type (80%). External opening was mostly located in the posterior mid zone (44.44%). Internal opening was found in 30 cases (66.66%) during per rectal digital examination while proctoscopic examination revealed internal opening in 26 cases (57.77%). Pain (22.22%), retention of urine (8.88%) were the commonest immediate as well as incontinence (1; 2.22%) and recurrence (1; 2.22%) were the delayed post-operative complications. 90% of cases had a satisfactory healing of their wounds within 21 days. Excellent results were achieved in 77.77% cases and only one case of recurrence (2.22%).

Conclusions: Encouragingly high success rates were achieved in our patients, but this series comprised a very small number of patients in a short period of time with limited amenities; also follow up of very short duration and irregular for which a definite conclusion is difficult to arrive at.


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