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CC BY-NC-ND 4.0 · Journal of Coloproctology 2021; 41(04): 355-360
DOI: 10.1055/s-0041-1736642
Original Article

Is Fistulotomy with Marsipulization more Effective than Fistulectomy alone for Low Fistula in Ano?

Danish Aslam
1   Department of General Surgery, Dow University of Health Sciences, Karachi, Pakistan
,
Farhan Zaheer
1   Department of General Surgery, Dow University of Health Sciences, Karachi, Pakistan
,
Sarush Ahmed Siddiqui 
1   Department of General Surgery, Dow University of Health Sciences, Karachi, Pakistan
,
Foad Ali Moosa
1   Department of General Surgery, Dow University of Health Sciences, Karachi, Pakistan
,
Shafaq Naseer
1   Department of General Surgery, Dow University of Health Sciences, Karachi, Pakistan
,
Rabia Arsalan
1   Department of General Surgery, Dow University of Health Sciences, Karachi, Pakistan
,
Muhammed Osama
1   Department of General Surgery, Dow University of Health Sciences, Karachi, Pakistan
› Author Affiliations
Source of Funding There is no potential source of funding to declare.
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Abstract

Background Fistula in ano is a very common perianal condition seen in outpatient departments. Fistulotomy and fistulectomy are two conventional options of surgery. The present study is designed to observe wound healing time and mean postoperative pain score in the comparison of outcome of the fistulectomy to fistulotomy with marsupialization.

Methods This prospective randomized trial was conducted in the surgical department of the Civil Hospital Karachi for a period of 12 months, in which 60 patients with low anal fistula were divided into 2 groups. Thirty patients in group A were treated with fistulectomy, and 30 in group B were treated with fistulotomy with marsupialization. The postoperative pain severity was assessed after 24 hrs through a visual analogue scale and on weekly and fortnightly follow-ups for 6 weeks. Wound healing was assessed by clinical examination on weekly and fortnightly follow-ups for 6 weeks to estimate the mean healing time.

Results The mean pain score was significantly lower in group B in comparison to group A (3.6 ± 1.99 versus 2.40 ± 1.52; p = 0.01). The mean wound healing time was shorter in group B in comparison to group A (4.23 ± 0.77 versus 5.80 ± 0.41 weeks; p = 0.0005).

Conclusion Fistulotomy with marsupialization is a simple, easy, and more effective method than fistulectomy for the treatment of simple perianal fistula.

Keywords

fistula in ano - fistulotomy with marsupialization - fistulectomy

Statement of Ethics

The subjects used in the study have given their consent, and the study protocol was approved by the institute's committee on human research. IRB number: IRB-1281/DUHS/Approval/2019


Authors Contribution

All authors played a role in designing the study, analyzing and intepreting the data, drafting the study, and ensuring authenticity of the data.




Publication History

Received: 01 February 2021

Accepted: 15 June 2021

Article published online:
13 December 2021

© 2021. Sociedade Brasileira de Coloproctologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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