Outcome of Open Fistulcectomy Versus Fistulectomy with Primary Closure in Low Level Fistula in Ano- Comparative Study

Abstract

Background: Fistula-in-ano form a major part of treatable benign lesions of the rectum and anal canal. 90% or more of these cases are end results of cryptoglandular infections.  Objective: To compare period of stay in hospital and duration for the wound to heal after open fistulectomy and fistulectomy with primary closure. Materials and methods:Patients admitted in all the surgical unit wards of Aarupadai Veedu Medical  College & Hospital, Kirumampakkam ,Puducherry  were  included  in  the   Study without bias on a serial basis. This is a randomized prospective study comprising 104 patients    (n =104) of Fistula in ano over a period of 24 months from October 2017 to October 2019. Results:The high incidence of cases was in the age group between 30- 50 years. The incidence was equal among both sexes. The common presenting features were swelling, pain and discharge from the external opening.  In the cases treated by classical method–excision of fistula tract and laying open of the wound and allowing to heal by granulation tissue from depth, the wound healing time was 3-6 weeks. In cases treated by excision of fistula tract and primary closure, the healing occured quickly, within a period of 7-14 days. Conclusion: Considering the benefits of primary closure over open fistulectomy, primary closure seems to be an ideal method for low level anal fistulas