CLINICAL CHARACTERISTICS AND RESULTS OF SURGICAL TREATMENT OF COMPLEX ANAL FISTULA AT BACH MAI HOSPITAL

Hiệp Nguyễn Thế, Hùng Nguyễn Ngọc

Main Article Content

Abstract

Objective: The study aims to review the clinical characteristics and evaluate the results of surgery for complex anal fistula at the Center of Digestive Surgery - Bach Mai hospital. Subjects and methods: Descriptive research on 52 patients with complex anal fistula, who had the surgery done from January 2023 to June 2024. Research results: the average age ranges from 42.5 ± 11.6 (years); the most common age is from 21 to 40 (42.3%); the male/female ratio is 12 (48/4); the rate of patients who had had surgery before was 11%. During surgery, 100% of patients had found the internal hole, 56.9% of the external hole and 64.2% of the internal hole were located in the posterior half of the anus. Classification of intraoperative lesions: intersphincteric fistula 3.9% (2 patients), low transsphincteric fistula 28.8% (15 patients), intermediate transsphincteric fistula 38.4% (20 patients), high transsphincteric fistula (13 patients) 25%, suprasphincteric fistula (2 patients) 3.9%. Fistulotomy was on 67.3%; Loose seton was on 5.8%, Combination of fistulotomy and drain placement procedure was on 19.2%, Combination of loose seton and drain placement procedure was on 7.7%. The rate of anal incontinence after surgery in the first 3 months and after 3 months is on 3.8% and 1.9%, respectively. The rate of recurrence is on 0%. The overall results includes: Good are on 98.1%; average are on 1.9% and poor are on 0%. Conclusion: Finding the internal fistula is the key to surgical success. The choice of surgical method must be appropriate to the classification of lesions.

Article Details

References

1. Nguyễn Xuân Hùng (2001), "Rò hậu môn hình móng ngựa: chẩn đoán và điều trị", Ngoại khoa, số 3, 54-58.
2. Avraham Belizon and Weiss E.G. (2010). Complex Anal Fistula, Coloproctology, Chapter 13, pp. 161–169
3. Adamina M., Ross T., et al (2014), “Anal fistula plug: a prospective evaluation of success, continence and quality of life in the treatment of complex fistulae”, Colorectal Disease, Vol 16, pp. 547-554.
4. Nguyễn Trung Tín, Bùi Xuân Cường (2012), “Kết quả điều trị áp xe hậu môn bằng phương pháp cột thun bó cơ thắt ngay khi rạch tháo mủ’’, Y Học TP Hồ Chí Minh, Tập 16 (1), 126-131 .
5. Nguyễn Hoàng Hòa (2016), “Nghiên cứu chẩn đoán và kết quả phẫu thuật điều trị rò hậu môn phức tạp”. Luận án tiến sỹ y học, Viện Nghiên cứu khoa học Y Dược lâm sàng 108.
6. Gordon P.H., Nivatvongs S. (1992): Principles and practice of Surgery for the colon, rectum and anus. Quality Medical Publishing-St Louis- Missouri- US of America.
7. Đỗ Đình Công (2007), “Nguyên nhân thất bại của điều trị phẫu thuật bệnh rò hậu môn”, Y Học TP Hồ Chí Minh, Tập 11 (1), 177-179
8. S. Leventog˘lu ., B. Ege., B. B. Mentes., et al (2013), “Treatment for horseshoe fistula with the modified Hanley procedure using a hybrid seton: results of 21 cases”, Tech Coloproctol, Vol 17(4), pp. 411-7