ABSTRACT

Aim: To find out factors potentially responsible for recurrence of fistula-in-ano in patients presenting at tertiary care hospital.

Study Design: Descriptive case series

Place and Duration: Study was conducted in the department of General Surgery at Liaquat Medical University Hospital Jamshoro for duration of six months from 1st July 2019 to 31st December 2019.

Methodology: 119 patients with recurrent anal fistula were included in this study. Brief history of duration of illness along with previous surgery and examination was carried out and specific investigations were advised if needed. All the patients had undergone surgical treatment. All potential factors responsible for recurrence were assessed. All this data was collected on a pre-designed proforma.

Results: The average age of the patients was 41.32±10.76 years. Complicated fistula tract was the most common causative factor i.e. 82.4% followed by inexperienced surgical hand 78.2%, Improper identification of tract 67.2%, Co-morbidities alongside anal fistula 41.2% and improper post-operative wound care 16.8%. Wound infection was observed in 21.61% (15/119) and anal incontinence 8.4% (10/119).

Conclusion: Complicated tracts (multiple & haphazard) was the most common factor responsible for recurrence of fistula-in-ano. We can conclude that proper assessment for diagnosis and appropriate management is the key to success. It not only reduces the complications but also improve the quality of life among these patient.

Key Words: Anal fistulae, anal discharge, perianal swelling, perianal pain, recurrent factors.