ĐẶC ĐIỂM LÂM SÀNG VÀ KẾT QUẢ PHẪU THUẬT RÒ HẬU MÔN PHỨC TẠP TẠI BỆNH VIỆN BẠCH MAI

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.