FISTULA IN ANO - A SURGICAL AUDIT

Objective: To document a 15 year experience of fistula in ano surgery. Design: Retrospective audit of patients. Subjects: All patients referred with fistula in ano between 1975 and 1990. Setting: Colorectal Service, University Department of Surgery, Wellington School of Medicine. Main outcome measures: Resolution of symptoms and morbidity of surgery. Results: 92 operations were performed in 88 patients. There were 65 males (39.6 year) and 23 females (25.9 year). Two patients were operated on two occasions and one patient with Crohn's disease (CD) had three fistulae laid open over a two year period. Three further patients with CD had one operation each. One patient had mucosal ulcerative colitis, one patient was found to have a carcinoma in situ close to the fistula tract and one had a carcinoma in the fistulous tract. There were no postoperative deaths. Over 50% of the patients were discharged within three days of surgery. No patient complained of anal incontinence at the time of discharge. Two patients returned with recurrence (a cryptogenic sepsis recurrence rate of 2.3%). Conclusion: Low fistulae in ano can be very satisfactorily managed by simple laying open. The recurrence rate following surgery is low, and there have been no complaints of problems with continence.