Anal fistulas: conventional treatment and postoperative results

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Résumé

Introduction: Anal fistula is the chronic form of Hermann et Desfosses gland infection. Objective: To study the therapeutic and evolutionary aspects in order to improve the management of anal fistulas.
Patients and Method: Descriptive case series study from January 1, 2005 to December 31, 2015 in two main private health facilities in the city of Ouagadougou. All patients operated
on for anal fistula were included in this study.
Results: We collected 50 cases of anal fistulas, representing 20.5% of all proctological pathologies. The mean age was 40.5 years, with a sex ratio of 5.25. Anal discharge was the functional symptom in 88% of cases. Hemorrhoidal disease was associated with anal fistula in 26% of cases. Treatment was surgical in all cases, and consisted of fistulectomy
alone or combined with seton drainage in 68%. A fistulotomy was performed in 22% of cases. Recurrence was noted in four patients, delayed healing in four and anal incontinence in two. The average hospital stay was 2.44 days. Operative mortality was zero.
Conclusion: Fistulectomy remains the most widely used surgical technique in our practice. Postoperative morbidity could probably be
reduced by the use of new techniques.

Mots-clés

Anal Fistula, Fistulectomy, Incontinence, Sphincter Sparing