대한대장항문학회

One hundred and seventy one cases of anal fistula including 27 cases underwent<br>fistulography at National Medical Center from 1986 to 1991 were reviewed for the<br>significance of fistulography in treatment of anal fistula and these were compared with<br>one hundred and twenty cases from 1981 to 1985.<br>The accepted classification of anal fistula was that of Parks(1976). The results in<br>cases underwent fistulography as for extensions, internal openings and types were<br>compared with the surgical findings.<br>The results were as follows.<br>1) The ratio of the male to female was 88.3 : 11.7 and the most frequent age group<br>was the second to third decades of life which occupied 81.3% of all cases in the second<br>half. These result didn't differ from the first half.<br>2) The recurrence rate didn't decrease at seconf half compared with<br>first(22.2%,<br>22.8%) because in the second half, high or complicated type increased(10.6% )<br>so<br>identification rate of internal opening fell to 69.0%.<br>3) In the analysis of fistulography compared with operation findings with reward to<br>internal openings, the accuracy was 68.4%, predictive value of positive test was 71%<br>and that of negative test was 67%. So fistulography was helpful to detect the<br>anatomical findings preoperatively if internal openings were identified on fistulography<br>and operation findings, both.<br>4) The recurrence rate of the group which internal openings were identified and that<br>which were not identified at the findings of fistulography were 22% and 17% but these<br>result revealed no significant statistic result by Fisher's exact test(p>0.05).<br>5) The recurrence free survival rate was 77.8%.<br>The above results suggested that fistulography was relatively useful for evaluation of<br>surgical anatomy preoperatively, in the case which was identified the internal openings if<br>fistulography underwent in selective cases, especially high or complicated or recurred<br>simple type.<br>