PMID- 34098630
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220506
IS  - 2287-9714 (Print)
IS  - 2287-9722 (Electronic)
IS  - 2287-9714 (Linking)
VI  - 38
IP  - 2
DP  - 2022 Apr
TI  - Long-term outcomes after anal fistula surgery: results from two university 
      hospitals in Thailand.
PG  - 133-140
LID - 10.3393/ac.2021.01.06 [doi]
AB  - PURPOSE: This study aimed to evaluate long-term outcomes after anal fistula 
      surgery from university hospitals in Thailand. METHODS: A prospectively collected 
      database of patients with cryptoglandular anal fistula undergoing surgery from 
      2011 to 2017 in 2 university hospitals was reviewed. Outcomes were treatment 
      failure (persistent or recurrent fistula), fecal continence status, and chronic 
      postsurgical pain. RESULTS: This study included 247 patients; 178 (72.1%) with 
      new anal fistula and 69 (27.9%) with recurrent fistula. One hundred twenty-one 
      patients (49.0%) had complex fistula; 53 semi-horseshoe (21.5%), 41 high 
      transsphincteric (16.6%), 24 horseshoe (9.7%), and 3 suprasphincteric (1.2%). 
      Ligation of intersphincteric fistula tract (LIFT) was the most common operation 
      performed (n=88, 35.6%) followed by fistulotomy (n=79, 32.0%). With a median 
      follow-up of 23 months (interquartile range, 12-45 months), there were 18 
      persistent fistulas (7.3%) and 33 recurrent fistulae (13.4%)-accounting for 20.6% 
      overall failure. All recurrence occurred within 24 months postoperatively. 
      Complex fistula was the only significant predictor for recurrent fistula with a 
      hazard ratio of 4.81 (95% confidence interval, 1.82-12.71). There was no 
      significant difference in healing rates of complex fistulas among seton staged 
      fistulotomy (85.0%), endorectal advancement flap (72.7%), and LIFT (65.9%) 
      (P=0.239). Four patients (1.6%) experienced chronic postsurgical pain. Seventeen 
      patients (6.9%) reported worse fecal continence. CONCLUSION: Overall failure for 
      anal fistula surgery was 20.6%. Complex fistula was the only predictor for 
      recurrent fistula. At least 2-year period of follow-up is suggested for detecting 
      recurrent diseases and assessing patient-reported outcomes such as chronic pain 
      and continence status.
FAU - Chadbunchachai, Weeraput
AU  - Chadbunchachai W
AD  - Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, 
      Thailand.
FAU - Lohsiriwat, Varut
AU  - Lohsiriwat V
AD  - Colorectal Surgery Unit, Department of Surgery, Faculty of Medicine Siriraj 
      Hospital, Mahidol University, Bangkok, Thailand.
FAU - Paonariang, Krisada
AU  - Paonariang K
AD  - Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, 
      Thailand.
LA  - eng
PT  - Journal Article
DEP - 20210607
PL  - Korea (South)
TA  - Ann Coloproctol
JT  - Annals of coloproctology
JID - 101605121
PMC - PMC9021857
OTO - NOTNLM
OT  - Chronic pain
OT  - Outcomes
OT  - Rectal fistula
OT  - Surgery
OT  - Treatment failure
COIS- No potential conflict of interest relevant to this article was reported.
EDAT- 2021/06/09 06:00
MHDA- 2021/06/09 06:01
PMCR- 2022/04/01
CRDT- 2021/06/08 00:46
PHST- 2020/09/30 00:00 [received]
PHST- 2021/01/06 00:00 [accepted]
PHST- 2021/06/09 06:00 [pubmed]
PHST- 2021/06/09 06:01 [medline]
PHST- 2021/06/08 00:46 [entrez]
PHST- 2022/04/01 00:00 [pmc-release]
AID - ac.2021.01.06 [pii]
AID - ac-2021-01-06 [pii]
AID - 10.3393/ac.2021.01.06 [doi]
PST - ppublish
SO  - Ann Coloproctol. 2022 Apr;38(2):133-140. doi: 10.3393/ac.2021.01.06. Epub 2021 
      Jun 7.