대한대장항문학회

This study presents the clinical features and the results of surgical treatment for<br>fistula-in-ano to unselected consecutive series of 194 patients which were treated at the<br>Department of Surgery, St. Benedict Hospital from Jan. 1988 to De. 1992.<br>The results were as follows;<br>1) Male to female ratio was 2.7：1 and the prevalent age group was<br>4th<br>decade(31.4%).<br>2) The symptoms were anal discharge in 104 cases(53.6%), pain in 76 cases(39.2%),<br>foreign body sensation in 34 cases(17.5%), constipation in 14 cases(7.2%), and anal<br>bleeding in 12 cases(6.2%).<br>3) The associated or previous anal diseases were anal pyogenic abscess in 75 cases,<br>hemorrhoid in 24 cases, anal fissure in 11 cases, and others in 3 cases.<br>4) The duration of symptom was variable; 86 cases(44.6%) under 6 months,<br>30<br>cases(15.5%) from 6 months to 12 months, 54 cases(27.8%) in 1 ∼5 years, and 24<br>cases(12.4%) over 5 years.<br>5) The distribution of anatomic classification was typeⅡ in 58.2%, typeⅢ in 26.8%,<br>typeⅣ in 8.8%, and typeⅠ in 6.2%.<br>6) The location of external or internal opening was mostly posteriorly in anus(34.8%<br>and 32.7%). The internal opening was not identified in 46 cases(23.5%).<br>7) The most common histopathological finding was chronic active nonspecific<br>inflammatory granulation in 90.7%.<br>8) The operative procedures included fistulectomy in 51 cases(26.3%), fistulotomy or<br>fistulectomy with drainage procedure in 113 cases(58.8%), muscle filling method in 3<br>cases(1%) and Seton technique in 27 cases(13.9%).<br>9) The overall postoperative complication rate was 23%; urinary retention in 23<br>cases(11.9%), recurrent fistula in 11 cases(5.7%), bleeding in 8 cases(4.1%), and infection<br>in 3 cases(1.5%).<br>