COMPARATIVE STUDY BETWEEN FISTULECTOMY AND FISTULOTOMY WITH MARSUPIALISATION IN THE TREATMENT OF SIMPLE ANAL FISTULA

Abstract

Background- Fistula-in-ano is one of the common ano-rectal disorder in Indian community which causes appreciable morbidity and discomfort to the patient.

Methods- Hospital based randomized comparative study conducted at Department of surgery, SMS hospital. 45 patients were taken in fistulectomy group and 35 in fistulotomy with marsupialization group. The primary outcome measure was wound healing time while secondary outcome measures were operating time, postoperative wound size, postoperative pain, wound infection.

Results- Postoperative Wound healed earlier in fistulotomy with marsupialisation group (4.30+0.64 weeks) than in fistulectomy group (7.38 +1.83 weeks). This difference in healing time reached statistical significance with a P-value of 0.0003. Wound size was smaller in fistulotomy with marsupialisation group (1.96 cm²+ 0.52) than fistulectomy group (3.38 cm² ± 0.46). Wound stops oozing earlier in fistulotomy with marsupialisation group ( 2.23 wk + 0.65) than in fistulectomy group (4.81 weeks + 0.79). No difference in pain score was noted in both the groups at 24 hour and 12 week after surgery.

Conclusion-Keeping in view the faster recovery, less duration of wound discharge, shorter wound healing time, smaller wound size and lower complications, it can be concluded that fistulotomy with marsupialisation is much safer and cost effective than the fistulectomy for the management of fistula in ano.

Keywords: Fistulectomy, Fistulotomy, Anal fistula