대한대장항문학회

Purpose: A fistula in ano is a granulating track between the anorectum and the perianal<br>region or perineum. A typical fistula may consist of the track, the primary (internal) opening<br>and secondary (external) opening. Its hallmark is frequent discharge through external opening.<br>Sometimes this track become occluded and a sinus remains. Therefore abscence of an external<br>opening should not be taken as evidence that there is no fistula, and then this study is aimed<br>to make clear perianal sinus as another form of fistula in ano.<br>Methods: This study is a clinical analysis of 17 patients with perianal sinus, who were<br>treated at the Department of General Surgery of Pundang-CHA hospital from June, 1995 to<br>December, 1998. As comparative group, 91 patients of typical fistula in ano were also taken<br>in same period.<br>Results: The ratio of male to female was 4.6：1 in sinus group, 4.1：1 in fistula group. The<br>prevalent ages were in the third decade in both group. The main symptoms of sinus group<br>were a palpable mass (94.1%), pain & discomfort (35.3%) but that of fistula group were<br>purulent discharge (87.9%) and pain (28.6%). The most frequent duration of illness was 6<br>months∼1 year (52.9%) in sinus group, within 6 months (40.7%) in fistula group. The<br>distributions of sinus size were 7 cases (41.2%) in ＜1 ㎝, 8 cases (47.0%) in 1∼2 ㎝ and<br>2 cases (11.8%) in ＞2 ㎝. The most common type was intersphincteric in both group. The<br>operative procedures included excision with fistulectomy in 4 cases (23.5%), lay open of sinus<br>with fistulotomy in 11 cases (64.7%), seton procedure in 2 cases (11.8%). The mean hospital<br>stay was 5.0 day in sinus group, 4.9 day in fistula group.<br>Conclusions: There was no distinct difference in the clinical features or characteristics<br>between the both groups, therefore perianal sinus could be taken as fistula in ano and treated<br>similar procedures.<br>