COMPREHENSIVE EVALUATION OF VARIOUS AVAILABLE SURGICAL MANAGEMENT OF FISTULA IN ANO :EXPERIENCE IN A TERTIARY CARE CENTRE OF INDIA

Abstract

BACKGROUND: There are various conventional and emerging surgical modalities for management of fistula in ano. But every modality has its own pros and cons. The aim of our study was to compare various surgical modalities in term of its recurrence rate, cost and their complication rates Materials and methods: A prospective observational study was conducted with 50 patients from July 2016 to June 2018. Prospective data was collected on proforma basis regarding clinical presentation, imaging findings, various surgical modalities, complications and reoperation rate. RESULTS: The mean age of the patients was 40.04 ± 10.77 years. The most common type of surgery was Fistulectomy (28%) and Fistula plug (28%) followed by Fistulotomy (20%), Seton Application (16%) and Video Assisted Anal Fistula Treatment (VAAFT) (8%).8 (16%) patients required reoperation. There was no significant association of reoperation and type of surgery in patients (p>0.05). The mean values of post-operative recovery (VAS Score) at different time intervals (post-op, post-op 3 months and post-op 6 months) was comparable and statistically not significant as per ANOVA test (p>0.05). There was no significant association of post-operative recovery (VAS Score) and type of surgery in patients. There was no significant association of post-operative complications after 3 months and 6 months and type of surgery in patients (p>0.05). CONCLUSION: All the surgical modalities used in our study revealed comparable success rate and no significant differences in complication rates. A large randomised controlled trial comparing various surgical modalities is required in future to decide the best surgical method to treat fistula in ano.