PMID- 36477051
OWN - NLM
STAT- MEDLINE
DCOM- 20221215
LR  - 20221215
IS  - 2078-5151 (Electronic)
IS  - 0038-2361 (Linking)
VI  - 60
IP  - 4
DP  - 2022 Dec
TI  - Thirteen-year audit of the management of anorectal fistulae in a tertiary 
      colorectal unit.
PG  - 235-241
LID - 10.17159/2078-5151/SAJS3191 [doi]
AB  - BACKGROUND: Persistent anorectal fistulae are referred for assessment in the 
      Durban Metropolitan area to the colorectal unit at the tertiary hospital. This 
      audit aimed to report the assessment and management of these fistulae to 
      benchmark the outcomes from these approaches at a South African tertiary 
      colorectal unit. METHODS: Retrospective analysis of prospectively collected data 
      of patients with anorectal fistulae over a 13-year period at a tertiary referral 
      centre. Data analysed included demographics, clinical presentation, comorbidity, 
      management and outcome. Study outcomes measures were healing time and secondary 
      outcome measures were complications of surgery. RESULTS: One hundred and 
      thirty-three patients (median age 44 and M:F ratio 2.8:1) with 206 fistulae were 
      accrued. The initial assessment and diagnostic procedures included insertion of 
      seton (126), fistulectomy (14), and fistulotomy (65). Definitive procedures 
      included two-stage seton fistulotomy (43), ligation of the inter-sphincteric 
      fistula tract (LIFT) procedure (39), modified Hanley procedure (17), and mucosal 
      advancement flap (5). One patient had no surgery and nine did not undergo a 
      definitive procedure. Additional procedures included anal sphincter 
      reconstruction (2) and repair of rectovaginal fistula (2). Residual anal 
      incontinence occurred in 13.5%. The failure rate was 6% and healing occurred in 
      94%. The median healing time was 8 months after the initial surgery and 4 months 
      following the definitive procedure. CONCLUSION: The fistula healing rate overall 
      was 94% and was associated with an incontinence rate of 13.5%.
CI  - Copyright(c) Authors.
FAU - Dube, G Q
AU  - Dube GQ
AD  - Colorectal Unit, Department of Surgery, University of KwaZulu-Natal, South 
      Africa.
FAU - Madiba, T E
AU  - Madiba TE
AD  - Colorectal Unit, Department of Surgery, University of KwaZulu-Natal, South 
      Africa.
FAU - Naidoo, M
AU  - Naidoo M
AD  - Colorectal Unit, Department of Surgery, University of KwaZulu-Natal, South 
      Africa.
FAU - Molla, Z
AU  - Molla Z
AD  - Colorectal Unit, Department of Surgery, University of KwaZulu-Natal, South 
      Africa.
FAU - Manzini, V
AU  - Manzini V
AD  - Colorectal Unit, Department of Surgery, University of KwaZulu-Natal, South 
      Africa.
LA  - eng
PT  - Journal Article
PL  - South Africa
TA  - S Afr J Surg
JT  - South African journal of surgery. Suid-Afrikaanse tydskrif vir chirurgie
JID - 2984854R
SB  - IM
MH  - Humans
MH  - Adult
MH  - Retrospective Studies
MH  - South Africa/epidemiology
MH  - *Fistula
EDAT- 2022/12/09 06:00
MHDA- 2022/12/15 06:00
CRDT- 2022/12/08 11:13
PHST- 2022/12/08 11:13 [entrez]
PHST- 2022/12/09 06:00 [pubmed]
PHST- 2022/12/15 06:00 [medline]
AID - 10.17159/2078-5151/SAJS3191 [doi]
PST - ppublish
SO  - S Afr J Surg. 2022 Dec;60(4):235-241. doi: 10.17159/2078-5151/SAJS3191.