Leczenie przetok odbytu w latach 2006-2012 w Katedrze i Oddziale Klinicznym Chirurgii Ogólnej i Gastroenterologicznej ŚUM w Bytomiu

*Angelika Copija¹, Julia Janiszewska¹, Paulina Maruszczak¹, Aleksandra Raźnikiewicz¹, Dariusz Waniczek², Jerzy Arendt²

Summary
Introduction. Fistula-in-ano (FA) is a canal surrounded by grain tissue connecting the internal opening in the anal canal at the level of anal crypts and the external opening on the skin surrounding the anus. It is a difficult problem, both for the patient, due to a chronic course, and the doctor because of a tendency to recurrence. Surgery is the only effective method of treatment.
Aim. The aim of the study was to present experiences in treatment of fistula-in-ano in the Department of General and Gastroenterological Surgery in Bytom in the years 2006-2012.
Material and methods. In the analyzed period from January 2006 to March 2012, 134 operations of FA were performed in patients aged 19-89 (mean 48.56): 102 (76.1%) men and 32 (23.9%) women.
Results. Recurrent fistula occurred in 42 (31.3%) patients, primary fistula in 92 (68.7%). Inter-sphincteric fistula was diagnosed in 37 (27.6%) patients, trans-sphincteric in 58 (43.3%), extra-sphincteric in 21 (15.7%), supra-sphincteric in 7 (5.2%) patients. There were also observed 4 (3.0%) subcutaneous and 7 (5.2%) submucous fistulas, not included in Park’s classification. 109 (81.3%) patients were treated by fistulectomy with partial closure of the wound or marsupialization and, if necessary, with partial incision of external sphincter. The method advancement flap repair was used in 16 (11.9%) patients, fistulotomy in 4 (3.0%), fistulectomy with excision and reconstruction of external sphincter in 5 (3.7%).
Conclusions. The majority of 134 patients treated in the years 2006-2012 had trans-sphincteric fistulas. Most of the patients were treated with fistulectomy with marsupialization.

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