ANALYSIS OF SURGICAL TREATMENT OF ANORECTAL FISTULAS IN A SERIES OF 158 PATIENTS

Introduction Anorectal fistulas are abnormal passages between the anal canal and the perianal skin or other adjacent structures. Most fistulas result from an infectious process in the anal glands, which can progress to an abscess and, in most cases, to a fistula. They represent about 70% of perianal diseases that require surgical treatment, with a prevalence of approximately 1 in 10,000 inhabitants per year, being more common in males. They are classified into four main types: intersphincteric, transsphincteric, suprasphincteric, and extrasphincteric, according to the relationship between the fistula tracts and the anal sphincter muscles.

Objective To evaluate the epidemiological profile and clinical outcomes of a series of patients undergoing surgical treatment for anorectal fistulas at a university hospital.

Methods Analysis of 158 patients surgically treated for anorectal fistulas between February 2010 and February 2024. Patients with a confirmed diagnosis of anorectal fistula were included, excluding those with inflammatory diseases. The variables analyzed were demographic data, diagnosis, symptom onset time, type of surgical treatment and its success rates, hospitalization time, and the need for a second intervention.

Results The average age of the patients was 41 years with a standard deviation of 11.70. Of the 158 patients, 66.45% were male. Fistulotomy was the most performed procedure, representing 77.8% of surgeries, with an average hospitalization time of less than 2 days. Only 7 patients (4.43%) required a second procedure. The higher male predominance (66.45%) suggests that men may have a higher risk of developing these conditions, possibly due to anatomical or behavioral factors. In addition to fistulotomy, other procedures performed included fistulectomy, intersphincteric fistula tract ligation (LIFT), and video-assisted fistula treatment (VAFT).

Conclusion Based on the results obtained in this series, it can be concluded that most fistulas have a cryptoglandular origin, and fistulotomy was the most commonly used treatment, showing resolution in the majority of cases.

No conflict of interest has been declared by the author(s).

Publication History

Article published online:
25 April 2025