Analysis of Clinical Value and Necessity of Preoperative Colonoscopy in Patients with Anal Fistula

Abstract

Abstract Background: To explore the clinical application value of preoperative colonoscopy in patients with anal fistula. Methods: (1) This study analyzed 1796 patients with benign anorectal diseases who underwent preoperative intestinal endoscopy and met the surgical criteria in the past three years at the First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine. Of these patients, 949 with anal fistula were classified as group A and 847 non-anal fistula patients were classified as group B. We compared and analyzed the general information, endoscopic findings, pathological characteristics of polyp, distribution of bowel-inflammation location, and inflammatory bowel disease examination results between the two groups of patients. (2) 2275 anal fistula patients without surgical contraindications in the past three years at the hospital were selected. Based on whether they underwent preoperative intestinal endoscopy, 949 anal fistula patients who underwent preoperative intestinal endoscopy were classified as group A and 1326 anal fistula patients who did not were classified as group C. This study compared the detection rate of endoscopic lesions and IBD results between the two groups of patients. Results: (1) There was no statistically significant difference in general information between groups A and B, indicating comparability. However, the abnormal detection rate in group A was higher than that in group B（P＜0.01）. In terms of endoscopic findings, the detection rate of bowel inflammation, IBD, and polyps in the anal fistula group was higher than that in the non-anal fistula group（P＜0.05）. Regarding the location of inflammation, group A exhibited a higher detection rate in the terminal ileum, ileocecal region, and ascending colon than group B（P＜0.05）. The incidence of IBD in group A was higher than that in group B, but there was no statistically significant difference between the two groups（P＞0.05）. (2) The study found that there was a statistically significant difference in the intestinal endoscopic detection rate between the two anal fistula groups (groups A and C)（P＜0.01）. The detection rate of IBD in the two anal fistula groups (groups A and C) had statistical significance（P＜0.05）. The detection rate of Crohn's disease in the two anal fistula groups (groups A and C) also had statistical significance（P＜0.05）. Conclusions: Preoperative colonoscopy is of great clinical value in the preoperative evaluation of patients with anal fistula, and it is necessary to perform preoperative colonoscopy to exclude localized perianal lesions caused by inflammatory bowel disease, thereby reducing the rate of missed diagnoses and improving treatment outcomes.