One-year outcome of fistulotomy: aprospective multi-centre study: LTP88


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Abstract

Aim:Fistula surgery has been associated with frequent recurrence and incontinence. We aimed to assess 1-year outcomes of fistulotomy.Method:Patients from ten Frenchproctological facilities, with fistulotomy between Jan-07 and Jun-08, wereproposed participation. Patients were examined before surgery and after healing. They self-assessed anal symptoms on both occasions and one year after surgery.Results:Overall 162 patients with simple transsphincteric fistula and 62 with complex fistula agreed to participate. The simple fistula group comprised 38 females, 22 of whom hadprior delivery. Fortyeight of these patients (30%) had emergency surgery due to abscess. One-year questionnaires were returned by 119 patients (73%). After 1 year, median Vaisey score was 2.5 [0-20] (vs 2 [0-14] before surgery). No new surgery for recurrence had occurred. The complex fistula group comprised 26 females, 16 of whom hadprior delivery. Twenty-six of these patients (42%) had emergency surgery due to abscess. One-year questionnaires were returned by 45 patients (73%). After 1 year, median Vaisey score was 4 [0-20] (vs 1.5 [0-11] before surgery). Three new surgeries for recurrence had occurred.Conclusion:When fistulotomy is performed by highly specialised surgeons, recurrence or anal incontinence is rare in simple fistulae and infrequent in complex fistulae.

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