Long-term outcomes after anal fistula surgery: results from two university hospitals in Thailand
Purpose: This study aimed to evaluate long-term outcomes after anal fistula surgery from university hospitals in Thailand. Methods: A prospectively collected database of patients with cryptoglandular anal fistula undergoing surgery from 2011 to 2017 in 2 university hospitals was reviewed. Outcomes w...
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th-mahidol.750172022-08-04T11:36:48Z Long-term outcomes after anal fistula surgery: results from two university hospitals in Thailand Weeraput Chadbunchachai Varut Lohsiriwat Krisada Paonariang Siriraj Hospital Faculty of Medicine, Khon Kaen University Medicine Purpose: This study aimed to evaluate long-term outcomes after anal fistula surgery from university hospitals in Thailand. Methods: A prospectively collected database of patients with cryptoglandular anal fistula undergoing surgery from 2011 to 2017 in 2 university hospitals was reviewed. Outcomes were treatment failure (persistent or recurrent fistula), fecal continence status, and chronic postsurgical pain. Results: This study included 247 patients; 178 (72.1%) with new anal fistula and 69 (27.9%) with recurrent fistula. One hundred twenty-one patients (49.0%) had complex fistula; 53 semi-horseshoe (21.5%), 41 high transsphincteric (16.6%), 24 horseshoe (9.7%), and 3 suprasphincteric (1.2%). Ligation of intersphincteric fistula tract (LIFT) was the most common operation performed (n = 88, 35.6%) followed by fistulotomy (n = 79, 32.0%). With a median follow-up of 23 months (interquartile range, 12–45 months), there were 18 persistent fistulas (7.3%) and 33 recurrent fistulae (13.4%)—account-ing for 20.6% overall failure. All recurrence occurred within 24 months postoperatively. Complex fistula was the only significant predictor for recurrent fistula with a hazard ratio of 4.81 (95% confidence interval, 1.82–12.71). There was no significant difference in healing rates of complex fistulas among seton staged fistulotomy (85.0%), endorectal advancement flap (72.7%), and LIFT (65.9%) (P = 0.239). Four patients (1.6%) experienced chronic postsurgical pain. Seventeen patients (6.9%) reported worse fecal continence. Conclusion: Overall failure for anal fistula surgery was 20.6%. Complex fistula was the only predictor for recurrent fistula. At least 2-year period of follow-up is suggested for detecting recurrent diseases and assessing patient-reported outcomes such as chronic pain and continence status. 2022-08-04T04:36:48Z 2022-08-04T04:36:48Z 2022-01-01 Review Annals of Coloproctology. Vol.38, No.2 (2022), 133-140 10.3393/ac.2021.01.06 22879722 22879714 2-s2.0-85129531687 https://repository.li.mahidol.ac.th/handle/123456789/75017 Mahidol University SCOPUS https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85129531687&origin=inward |
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Medicine Weeraput Chadbunchachai Varut Lohsiriwat Krisada Paonariang Long-term outcomes after anal fistula surgery: results from two university hospitals in Thailand |
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Purpose: This study aimed to evaluate long-term outcomes after anal fistula surgery from university hospitals in Thailand. Methods: A prospectively collected database of patients with cryptoglandular anal fistula undergoing surgery from 2011 to 2017 in 2 university hospitals was reviewed. Outcomes were treatment failure (persistent or recurrent fistula), fecal continence status, and chronic postsurgical pain. Results: This study included 247 patients; 178 (72.1%) with new anal fistula and 69 (27.9%) with recurrent fistula. One hundred twenty-one patients (49.0%) had complex fistula; 53 semi-horseshoe (21.5%), 41 high transsphincteric (16.6%), 24 horseshoe (9.7%), and 3 suprasphincteric (1.2%). Ligation of intersphincteric fistula tract (LIFT) was the most common operation performed (n = 88, 35.6%) followed by fistulotomy (n = 79, 32.0%). With a median follow-up of 23 months (interquartile range, 12–45 months), there were 18 persistent fistulas (7.3%) and 33 recurrent fistulae (13.4%)—account-ing for 20.6% overall failure. All recurrence occurred within 24 months postoperatively. Complex fistula was the only significant predictor for recurrent fistula with a hazard ratio of 4.81 (95% confidence interval, 1.82–12.71). There was no significant difference in healing rates of complex fistulas among seton staged fistulotomy (85.0%), endorectal advancement flap (72.7%), and LIFT (65.9%) (P = 0.239). Four patients (1.6%) experienced chronic postsurgical pain. Seventeen patients (6.9%) reported worse fecal continence. Conclusion: Overall failure for anal fistula surgery was 20.6%. Complex fistula was the only predictor for recurrent fistula. At least 2-year period of follow-up is suggested for detecting recurrent diseases and assessing patient-reported outcomes such as chronic pain and continence status. |
author2 |
Siriraj Hospital |
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Siriraj Hospital Weeraput Chadbunchachai Varut Lohsiriwat Krisada Paonariang |
format |
Review |
author |
Weeraput Chadbunchachai Varut Lohsiriwat Krisada Paonariang |
author_sort |
Weeraput Chadbunchachai |
title |
Long-term outcomes after anal fistula surgery: results from two university hospitals in Thailand |
title_short |
Long-term outcomes after anal fistula surgery: results from two university hospitals in Thailand |
title_full |
Long-term outcomes after anal fistula surgery: results from two university hospitals in Thailand |
title_fullStr |
Long-term outcomes after anal fistula surgery: results from two university hospitals in Thailand |
title_full_unstemmed |
Long-term outcomes after anal fistula surgery: results from two university hospitals in Thailand |
title_sort |
long-term outcomes after anal fistula surgery: results from two university hospitals in thailand |
publishDate |
2022 |
url |
https://repository.li.mahidol.ac.th/handle/123456789/75017 |
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1763498125676249088 |