ABSTRACT

Recurrence and incontinence are the most serious complications after perianal fistulas surgery. We aimed to investigate the effect of surgery method on recurrence and incontinence.

A total of 90 patients with fistula-in-ano between January 2012 and May 2014 at Samsun Education and Research Hospital were retrospectively analyzed. Demographics, past-surgical history, co-morbidities, recurrence rates, the difference between pre- and postsurgical Wexner Incontinence Scores (DWIS) were all evaluated.

The study involved 90 patients (22 female, 68 male) with anal fistula whose average age was 43.9 years (range: 18-81). 30 of 57 patients who had complex anal fistula underwent LIFT. ( 8 core out fistulectomy (COF), 19 seton procedure). Furthermore, 33 of the patients who had simple fistula were treated by fistulotomy. The follow-up period for LIFT group was 14.3 months (range: 3-32).In fistulotomy group 1 (3 %), in COF group 1 (12.5 %), in seton group 4 (21.1 %) and in LIFT group 8 (26.7%) patients had anal fistula surgery history. In follow-up, 19/90 (21.1%) patients recurred.In LIFT group 3 (10%), in fistulotomy group 5 (15.2%), in COF group 6 (75%) and in seton group 5 (26.3%) patients had recurrence. Recurrence rate in the COF group was higher than the LIFT group (p = 0.001). There was no difference in recurrence between fistulotomy groups compared seton and LIFT groups (p = 0.233, p = 0.714).There was no statistically significant difference between fistulotomy and LIFT groups for DWIS (p = 0.083).In the LIFT group compared setone and COF was significantly lower DWIS (p <0.001, p = 0.023).

In our experience, LIFT method seems easy to perform with better incontinence rate and healing results when compared with conventional methods for complex fistulas.