Abstract
PURPOSE: The aim of this study was to analyze failures in the operative management of perirectal abscesses resulting in early reoperation. METHODS: This was a retrospective case study of 500 consecutive patients who underwent 627 drainage procedures for a perirectal abscess. RESULTS: Forty-eight patients (7.6 percent of all drainage procedures) required reoperation within ten days of the original procedure. The main factors leading to reoperation were incomplete drainage (23 patients), missed loculations within a drained abscess (15 patients), missed abscesses (4 patients), and postoperative bleeding (3 patients). Incomplete drainage was more common with simple perirectal abscesses, whereas most overlooked collections were located posteriorly. Horseshoe abscesses were associated with a particularly high rate (50 percent) of operative failures. Neither preexisting perianal pathology nor systemic immunosuppressive disease contributed to early failures. CONCLUSION: Surgical errors are the leading cause of early failures in the surgical treatment of perianal abscesses. These errors occur in a limited number of typical patterns and can therefore be identified and taught with an aim to decrease their occurrence.
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References
Hyman N. Anorectal abscess and fistula. Prim Care 1999;26:69–80.
Sailer M, Bussen D, Debus ES, Fuchs KH, Thiede A. Quality of life in patients with benign anorectal disorders. Br J Surg 1998;85:1716–9.
Read DR, Abcarian H. A prospective survey of 474 patients with anorectal abscess. Dis Colon Rectum 1979;22:566–8.
Cox SW, Senagore AJ, Luchtefeld MA, Mazier WP. Outcome after incision and drainage with fistulotomy for ischiorectal abscess. Am Surg 1997;63:686–9.
Tang C-L, Chew S-P, Seow-Choen F. Prospective randomized trial of drainage alonevs. drainage and fistulotomy for acute perianal abscesses with proven internal opening. Dis Colon Rectum 1996;39:1415–7.
Nagle D, Rolandelli RH. Primary care office management of perianal and anal disease. Prim Care 1996;23:609–20.
Mortensen J, Kraglund K, Klaerke M, Jaeger G, Svane S, Bone J. Primary suture of anorectal abscess: a randomized study comparing treatment with clindamycinvs. clindamycin and Gentacoll®. Dis Colon Rectum 1995;38:398–401.
Fielding MA, Berry AR. Management of perianal sepsis in a district general hospital. J R Coll Surg Edinb 1992;37:232–4.
Ho Y-H, Tan M, Chui C-H, Leong A, Eu K-W, Seow-Choen F. Randomized controlled trial of primary fistulotomy with drainage alone for perianal abscesses. Dis Colon Rectum 1997;40:1435–8.
Ramanujam PS, Prasad M, Abcarian H, Tan AB. Perianal abscesses and fistulas: a study of 1023 patients. Dis Colon Rectum 1984;27:593–7.
Chrabot CM, Prasad M, Abcarian H. Recurrent anorectal abscesses. Dis Colon Rectum 1983;26:105–8.
Shafik A. A new concept of the anatomy of the anal sphincter mechanism and the physiology of defection. VI. The central abscess: a new clinicopathologic entity in the genesis of anorectal suppuration. Dis Colon Rectum 1979;22:336–41.
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Onaca, N., Hirshberg, A. & Adar, R. Early reoperation for perirectal abscess. Dis Colon Rectum 44, 1469–1472 (2001). https://doi.org/10.1007/BF02234599
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DOI: https://doi.org/10.1007/BF02234599