2016 Volume 69 Issue 4 Pages 197-204
High intersphincteric abscesses sometimes have poor clinical symptoms and may be difficult to diagnose. In addition, a certain percentage of cases can be completely cured without radical surgery for anal fistula by only medical treatment, such as conservative medical treatment and drainage therapy.
As factors for deciding whether or not to perform radical surgery, the duration of illness, presence or absence of diabetes, fever, white blood cells, and type of drainage therapy were studied.
Drainage therapy involves a basic incision from the intersphincteric approach, and if a drainage seton is necessary, drainage therapy is made from outside the external sphincter. After drainage therapy, radical operation for anal fistula was performed in 15% of cases, and there was no case in which radical operation was performed after conservative medical treatment.
The number of cases in which drainage therapy was made from outside the external sphincter was significant (P<0.05), but there was no significant difference for the other factors.
After medical treatment for high intersphincteric abscesses, relatively few cases require radical operation for fistulas. It is important to determine the treatment method based on the presence or absence of a fistula after a sufficient observation period.
