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Is simple fistula-in-ano simple?

  • Original Contributions
  • Published:
Diseases of the Colon & Rectum

Abstract

PURPOSE: A study of 523 fistulas of cryptoglandular origin operated on between January 1985 and December 1991 at the Lehigh Valley Hospital was undertaken for the purpose of establishing whether the “so-called” simple fistula-in-ano has a favorable outcome. High transsphincteric fistulas with or without high blind track, suprasphincteric, extrasphincteric, and horseshoe fistulas as well as fistulas associated with inflammatory bowel disease were excluded. METHODS: Four-hundred sixtyone patients with anal fistulas classified as simple fistulasin-ano (uncomplicated transsphincteric, low and high blind track intersphincteric) were studied retrospectively. There were 310 males and 151 females with an average age of 42 years and mean follow-up of 34 months. RESULTS: Thirty (6.5 percent) patients developed recurrent fistulas: 16 (53.3 percent) beacuse of missed internal openings at initial surgery, six (20 percent) attributed to missed secondary tracks, five (16.7 percent) because of premature fistulotomy wound closure, and three (10 percent) because of miscellaneous factors. CONCLUSION: All so-called simple fistulas-in-ano may not have readily detectable primary openings and may possess secondary tracks which preclude their behavior as simple fistulas.

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Authors and Affiliations

  1. Division of Colon & Rectal Surgery, Lehigh Valley Hospital, Allentown, Pennsylvania

    Yash Pal Sangwan M.D.,  Les Rosen M.D., Robert D. Riether M.D., John J. Stasik M.D., James A. Sheets M.D. & Indru T. Khubchandani M.D.

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  1. Yash Pal Sangwan M.D.
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  2. Les Rosen M.D.
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  3. Robert D. Riether M.D.
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  4. John J. Stasik M.D.
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  5. James A. Sheets M.D.
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  6. Indru T. Khubchandani M.D.
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Additional information

Read at the annual meeting of the Ohio Valley Society of Colon and Rectal Surgeons, Columbus, Ohio, April 17, 1993, and at the spring meeting of the New England Society of Colon and Rectal Surgeons, Brewster, Massachusetts, April 24, 1993.

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Sangwan, Y.P., Rosen, L., Riether, R.D. et al. Is simple fistula-in-ano simple?. Dis Colon Rectum 37, 885–889 (1994). https://doi.org/10.1007/BF02052593

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