대한대장항문학회

This study is a clinical review of 154 patients with fistula-in-ano, which were treated<br>at the Department of General Surgery of Ewha Womans University Hospital from<br>January, 1993 to December, 1996.<br>The male to female ratio was 4:1, and the prevalent of groups were in the 3rd and<br>4th decade. The symptoms were anal discharge in 123 cases(79.8%), pain in 21 cases<br>(13.6%), palpable mass in 9 cases(5.8%). 53.8% of the patients showed a duration of<br>symtoms which were within 6 mouths. The previous or combined anal diseases were<br>anal abscess in 62.4%, postfistulectomy in 29.0%, hemorrhoid in 4.3%, and anal fissure<br>in 1.2%. The histopathologic etiologies were chronic non-specific inflammation in 94.8%,<br>and tuberculosis in 3.2%. 38.8% of the patients showed an external openings in the<br>anterior midline, 25.9% in the posterior midline, 13.0% in the left lateral, and 10.4% in<br>the right lateral portion of the anus. In 84.4% of the patients, the interval opening was<br>identified. The intersphincteric type was the most common. The operative procedures<br>included fistulotomy with lay open in 129 cases(83.8%), fistulotomy with seton in 16<br>cases(10.4%), and fistulectomy in 8 cases(5.2%). The days of hospital stay were mostly<br>within 14 days.<br>The main postoperative complications were urinary retention and reccurance, which<br>were identified in 4.6% each of the patients. The acuracy and the predictive value of<br>fistulography, a method of identification of the internal openings showed an accuracy of<br>73%, the predictive value of positive tests was 95% and that of the negative test was<br>30%.<br>