Outcome of different surgical procedures for fistula-in-ano: a single centre-based study


  • Jahangeer M. Bhat Department of Health Services, Jammu and Kashmir, India
  • Humayoon Rasool Department of General Surgery, SKIMS Medical College, Bemina, Srinagar
  • Naveed Nabi Department of General Surgery, SKIMS Medical College, Bemina, Srinagar
  • Insha Rasool College of Nursing, Islamic University of Science and Technology, Jammu and Kashmir, India
  • Nisar Chowdri Department of Colorectal Surgery SKIMS Soura, Srinagar
  • Fazl Qadir Parray Department of Colorectal Surgery SKIMS Soura, Srinagar




Fistula-in-ano, Fistulectomy, Seton, Recurrence


Background: Fistula-in-ano is an abnormal communication between anal canal/rectum and perianal skin. It is considered to be chronic sequelae of cryptoglandular perianal abscess. Surgical treatment is the standard of care. However, the surgical techniques have evolved over time in order to give a satisfactory non-recurring result without jeopardising continence mechanism. Our aim was to study the feasibility and outcome of various surgical procedures done for fistula-in-ano.

Methods: This study was conducted in colorectal division of department of general surgery SKIMS Srinagar, from 2017-2019. All patients underwent a surgical procedure which was deemed feasible for a particular case. Pre-operative data and post-operative outcome/complications were studied over a mean follow up of 12 months. Final inferences were drawn after analysing the data using various statistical tools.

Results: Fistula-in-ano has male predominance (8:1), with intersphincteric fistula being the commonest type (48%) in our study. Majority of our patients underwent fistulectomy (72.5%) with or without Seton placement. Over a mean follow up of 12 months, only 19 patients (15.32%) developed recurrence. Incontinence was observed in 15 patients (12.09%). The risk of recurrence was observed to be directly related to the complexity of fistula.

Conclusions: Fistulectomy is safe and effective for low intersphincteric and trans-sphincteric fistulas with acceptable rates of recurrence. Benefit of radical excision in high fistulas with multiple secondary tracts should be carefully weighed against risk of post-operative incontinence.



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