Anal fistula surgery in an outpatient setting: the Dubai experience

• Autor(a) principal: Hazim,Wessam
• Data de Publicação: 2015
• Outros Autores: Al-Ozaibi,Labib, Azam,Hadiel, Al-Mazrouei,Alya, Al-Badri,Faisal
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Journal of Coloproctology (Rio de Janeiro. Online)
• Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S2237-93632015000100042
• topic: Anal fistula; Proctology; Ambulatory surgery; Day case surgery

AIM: To determine whether surgery for transsphincteric and complex fistula-in-ano can be performed safely as a day case. METHOD: This is a retrospective study of 66 patients with transsphincteric and complex anal fistulas, initially managed with preliminary loose Seton followed by fistulectomy and sphincter repair 2-4 months later between March 2011 and March 2014. Patients were seen at the clinic 1 week, 3 months and 1 year post-operatively and were observed for complications and recurrences; incontinence was noted down and was graded according to the Cleveland Clinic score. RESULT: Twenty-five patients (38%) had high or complex fistulas and 32 (48.5%) had a history of previous surgery. All cases were done in an outpatient setting. The Seton was kept in situ for 2-5 months (2.6 months) followed by fistulectomy and sphincter repair. Complete healing was achieved within approximately 3.6 weeks (2-8 weeks). Fifty-one patients were followed up successfully for one year. Two patients had temporary flatus incontinence which had resolved over 2-3 months. Recurrence had occurred in 2 (3.9%) patients. CONCLUSION: Transsphincteric and complex fistulas can safely be operated on as day case surgeries with high patient satisfaction and less complication in the population we studied.