FISTULA IN ANO;

PRESENTATION AND POSTOPERATIVE OUTCOME OF THE DIFFERENT SURGICAL PROCEDURES IN LOW TYPE.

Abstract

Objective: This study was planned to find out the clinical presentation and postoperative outcome of different surgical
procedure in low type in low fistula in Ano. Design: Prospective observational study. Place and duration of the study: Study was
conducted in teaching hospital setting at LUMHS Jamshoro, Zia ud Din Teaching Hospital Karachi and DHQ JMC Teaching Hospital
Charsadda. Liaquat University in Surgical Unit-I Jamshoro from May 2010 to June 2012. Patients Methods: One seventy cases of low
type fistula in Ano with single external opening, irrespective of age and sex admitted in surgical unit-I, were examined. Mean age was 37
years, patient’s rages from (15-60 years). Patients having high type fistula in ano identified pre and per operatively excluded from the
study. A detailed history physical examination including local examination of anorectum focusing on the level of internal opening.
Investigation like fistulogram done in selected case. Fistulectomy and fistulotomy performed in all these cases and patient followed up
minimum upto the 6 months time. Results: Maximum Number of cases were seen in 3rd,4th, decade of life 50 (29.6%) and 64 (37%)
respectively. Mean age was 37 ranges from 15 to 60 years. Out of 172 patients 142 (85.7%) male and 24 (14.3%) female. Male to female
ratio was 6.1:1. Majority of patients one forty two (82%) presented with discharge. Discharge along with swelling in 132 (76.7%).
Hundred twelve (65%) underwent fistulectomy, 38 (22%) of the patients got fistulotomy and (12%) of patients underwent fistulectomy
along with haemorrhoidectomy and fissurectomy. A total of 72 (41.4%) patients experience different post operative, surgical and
anesthetic complications. Conclusions: Incidence of low type fistula in ano is higher in 3rd and 4th decade of life. The disease was found
more common in male, discharge, pain, itching are common symptoms of low type fistula in ano. In low type fistula in ano fistulotomy is
safe procedure. Post operative complications can be prevented by careful treatment efforts.