A 30 YEAR EXPERIENCE IN THE MANAGEMENT OF ANAL FISTULA

Anal fistula has been recognized for centuries, and yet, its treatment remains challenge for surgeons till today. In this study, a 30 year experience of treating anal fistula is being reported and discussed in light of the various recognized management methods A total of 320 patients were treated by fistulotomy, fistulectomy, fistula plugging or seton technique Data showed that fistula plugging carried the highest failure rate (89%) seconded by fistulectomy (37%), seton procedure (24.5%) and fistulotomy (15.6%). High transsphincteric fistulas were more likely to predict failure compared to low transphincteric, intersphincteric and subcutaneous fistulas (37.5% versus 9.5%, 7.3% and 0%, respectively). In conclusion, the scales seem to support fistulotomy. However, no standardized algorithm exists to guide the care of patients and the choice of operation is based on patient-related factors, the patient's surgical history, and the surgeon's experience and familiarity with the various techniques for treating anal fistula