Experience in the treatment of complex perianal fistulas in a public hospital. 2018-2022

Abstract

Introduction: Complex perianal fistula treatment is controversial; it requires a precise anatomical and auxiliary diagnosis methods’ knowledge to offer the best result possible for the patient. Objective: To describe the experience of complex perianal fistula treatment within the Public Hospital during the 2018 - 2022 period. Materials and Methods: Observational, descriptive, cross sectional, non-probabilistic study of consecutive patients with a complex perianal fistula diagnosis admitted to coloproctology services in the Itauguá National Hospital during the January 2018 - December 2022 period, of which 21 fit the complex perianal fistula criteria. Results: Of the 21 patients, 76% were male, with an average age of 35 ± 10 years old, the main consultation reason was anal secretion in 19 patients. Regarding the fistula type, an 81% high transsphincteric fistula was identified, as for the treatment, in 48% a fistulectomy was performed, and regarding complications, only 10% of patients suffered from fistula recurrence which was treated through a fistulectomy with seton placement. Conclusion: Complex perianal fistula is an infrequent periorificial pathology, the data obtained from physical examination and the possibility to effectuate complementary studies with advanced technological resources are fundamental to a satisfactory resolution.