Long-term Results of Primary Lesion Opening Surgery (Localized Laying Open Method) for Anal Fistula

Abstract

Purpose
We performed primary-focus open operations to treat anorectal fistulas and assessed the condition of 125 patients at 5 years or more after the operation.
Subjects and Methods
During the period between May 1991 and May 2002 we performed primary-focus open operations (excision including the primary opening, primary fistulous tract, internal anal sphincter, primary focus, subcutaneous external anal sphincter or incision and creation of an open wound) to treat 125 cases of anal fistula (low 8, high 117). The postoperative course was confirmed from the contents of the patients' charts and by a questionnaire survey by mail.
Results
1. Wound healing occurred in 117 (94%) of the 125 cases. 2. There were no recurrences in 88 (70%) of the cases. 3. Anal manifestations developed in 12 (24%) of the 50 cases in which it was possible to determine the condition of the anus postoperatively, and manifestations of anal sphincter muscle incompetence associated with the operation were seen in 11 (22%) of them, i.e., gas leakage in 5 cases, underwear soiling in 2 cases, fecal incontinence occasionally in 3 cases, and frequently in one case.
Conclusions
We concluded that primary-focus open surgery is partially effective as a curative operation for anal fistulas.