Background: Fistula in Ano is a chronic abnormal communication runs outward from anorectal lumen (int opening) to an external opening on the skin of perineum or buttock. History of ischiorectal, perianal abscess is the main hindering reason. Tuberculosis, IBD (Crohns or ulcerative proctocolitis), trauma can also lead to development of anal fistula. Sometimes termed as nonspecific, idiopathic or cryptoglandular and intersphincteric anal gland infection. chronic discharge, occasional pain and blood staining, foul smelling, cloths soiling and disturbance in religious purposes for muslims are the reasons to operate.
Objectives: To specify duration of healing in low variety fistula in Ano after surgery and staying time in Hospitals. Other concomitant issues in perioperative period.
Methodology: This cross sectional study was carried out in Bangabandhu sheikh Mujib Medical university from April to Sept 2012. Total 50 patients were selected as study population whom were admitted with low anal fistula and internal opening is below anorectal ring. Horse shoe, high variety fistula, associated disease (TB, IBD), malignancy were excluded from study population. Patient were grouped in A and B. A for Fistulectomy and B for fistulotomy. 25 patients in Group A, 25 patients in Group B. surgery was conducted by spinal anaesthesia and preoperatively 1 gm ceftriaxone and 1 bottle (500 gm) metronidazole given in each patient. Patients were discharged in 2nd post operative day with some guidelines and education of treatment maneuver. First follow up after 7 days and 2nd follw up after 4 wks.
Results: Total 50 patients admitted in BSMMU surgery Department and grouped in A (Fistulectomy) and B (Fistulotomy). Age range was 20-70 yrs and male are suffered more than female. low socioeconomic groups are presented more with history of anorectal abscess. Mean hospital stay was more in Fistulectomy with raised pain score than fistulotomy.
Conclusion: Anal fistula is a common cause of chronic pain and anal nuisance. Delineation of anal anatomy and identification of fistulas tract is important to prevent recurrence. Fistulotomy patient has less post operative pain with less hospital stay than fistulectomy in low variety anal fistula.
Keywords: Fistulectomy; Fistulotomy; Low variety fistula
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