Retrospective Analysis of the Surgical Treatment of Anorectal Fistulas in a University Hospital: Surgical Results and Predictive Factors of Relapse and Anal Continence

Isaac José Felippe Corrêa Neto, Janaína Wercka, Diego Palmeira Rangel, Angelo Rossi da Silva Cecchini, Hugo Henriques Watté, Rogério Freitas Lino Souza, Alexander Sá Rolim, Rodrigo Ambar Pinto and Laercio Robles

Department of General Surgery and Coloproctology, Hospital Santa Marcelina-SP, Brazil
Department of Coloproctology, Santa Marcelina Hospital-SP, Brazil
Department of Gastroenterology, University of São Paulo, Brazil
Department of General Surgery, Santa Marcelina Hospital-SP, Brazil

^*Correspondance to: Isaac Jos� Felippe Corr�a Neto 

 PDF  Full Text DOI: 10.25107/2474-1647.1976

Abstract

Objective: Retrospective analysis of the patients submitted to surgical treatment of anorectal fistula in a teaching hospital, in relation to the preoperative data, procedure performed and factors predictive of relapse and anal incontinence.Introduction: Anorectal fistula is a condition commonly found in surgical practice with an incidence of about 1 in 10,000 individuals with a predisposition to the male sex, occurring mainly in patients between 30 and 50 years of age and in 80% of the cases originates from infection in the glandular crypts (cryptoglandular). Its treatment can have as main consequences the relapse and anal incontinence.Methods: A retrospective cohort of patients submitted to surgical treatment of anorectal fistula was analyzed at Santa Marcelina Hospital, São Paulo, between January 2011 and September 2015, based on the analysis of data collected in a prospective electronic medical record. The criteria for non-inclusion were: patients with a history of trauma, urologic, colorectal or gynecological causes, neoplasms, and those with inflammatory bowel disease. The remaining patients with cryptoglandular fistula consecutively operated in the aforementioned period were included in the study.Results: A total of 200 patients submitted to surgical treatment of anorectal fistula were analyzed. Among men, there was a higher incidence of hypertensive patients (0.03), diabetics (0.05), older age (p=0.001), and in women previan abscess was predominant (p=0.001). An overall relapse rate of 13% and a transsphincteric (p=0.044) and extra-sphincter (p=0.005) positions were found. Regarding anal incontinence complaints, even in the first 3 months postoperatively, there was an association with previous abscess (p=0.034), number of pregnancies (p=0.019) and anterior orifice surgery (p=0.021).Conclusion: In the present study with analysis of patients submitted to surgical treatment of anorectal fistula, there was a predominance of male patients and a low incidence of recurrence and symptoms of anal continence disorders, in addition to a predominance of complex fistulas.

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Cite the article

Neto IJFC, Wercka J, Rangel DP, da Silva Cecchini AR, Watt� HH, Souza RFL, et al. Retrospective Analysis of the Surgical Treatment of Anorectal Fistulas in a University Hospital: Surgical Results and Predictive Factors of Relapse and Anal Continence. Clin Surg. 2018; 3: 1976.