대한대장항문학회

The authors performed a retrospective review to find out optimal treatment plan in<br>infantile fistula-in-ano. There were seventy-one patients in a 2-year period. All were<br>male and other clinical characteristics were similar to previous reports.<br>The onset in 60 patients(97%) of the cases was in the first 1 year of alee, especially<br>in the first 3 months(52%). We investigated patterns of disease progression in<br>multiple-lesion cases(19cases 29%). In 5 out of 9 cases of which we could identify the<br>patterns, new lesion developed from 1 month to 4 months after index lesion. Fifty<br>Patients underwent fistulotomy under principle of early surgical intervention, No<br>recurrence was found except 2cases who needed second operation during 30 months of<br>median follow-up(23∼48 months). In 21 patients whose parents did not want operation,<br>we performed simple drainage and followed-up. Six out of 12 patients who could be<br>communicable had no fistula-related symptoms from 20 months to 31 months. This<br>suggests that simple drainage has therapeutic effect in some portion of infantile abscess.<br>We conclude that simple drainage should be initial treatment of choice in infantile<br>perianal abscess. We suggest that definite operation for recurrent abscess and fistula<br>with relatively mild symptoms should be delayed until 1-year of age because of interval<br>occurrence of multiple lesions and therapeutic effect of simple drainage.<br>