Radiofrequency fistulotomy
a better alternative for treating low anal fistula
Keywords:
Rectal fistula, Recurrence, Anus, Radio waves, Colorectal surgeryAbstract
CONTEXT: Wide varieties of approaches are employed in dealing with low anal fistula. However, the simple method of laying open the fistula tract (fistulotomy) is still considered to be the favored one. MATERIALS AND METHODS: A modified approach to the procedure of fistulotomy is discussed. This study describes the procedure, which used a technique of radiofrequency surgery, and its outcome in 232 patients with low anal fistula. The patients were followed for a period of 15 months. RESULTS: The patients were discharged on the same day as the procedure. The mean period off work was four days. The average healing time recorded was 67 days. Four wound complications in the form of premature closure of the external wound were noted, which required trimming of the edges. Two of these wounds remained unhealed. The recurrence rate was 1.7%. CONCLUSION: In this era when the emphasis is on criteria like the minimization of hospital stay, reduction of postoperative pain, early resumption of work and low and comparable recurrence rates, there is a future for the procedure of radiofrequency fistulotomy.
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References
García-Aguilar J, Davey CS, Le CT, Lowry AC, Rothenberger fistula kezelése. [Treatment of anal fistulas]. Magy Seb. 2002;45(12):1622-8. DA. Patient satisfaction after surgical treatment for fistula-in- ano. Dis Colon Rectum. 2000;43(9):1206-12.
Pfenninger JL, Zainea, GG. Common anorectal conditions: Part II. Lesions. Am Fam Physician. 2001;64(1):77-88
Gunawardhana PA, Deen KI. Comparison of hydrogen peroxide instillation with Goodsall’s rule for fistula-in-ano. ANZ J Surg. 2001;71(8):472-4.
Plant RL. Radiofrequency treatment of tonsillar hypertrophy. Laryngoscope. 2002;112(8 Pt 2):20-2.
Rex J, Ribera M, Bielsa I, Paradelo C, Ferrándiz C. Surgical management of rhinophyma: report of eight patients treated with electrosection. Dermatol Surg. 2002;28(4):347-9.
Ho YH, Tan M, Leong AF, Seow-Choen F. Marsupialization of fistulotomy wounds improves healing: a randomized controlled trial. Br J Surg. 1998;85(1):105-7.
Ereifej S, Lestár B, Hornok L, Ritter L, Kiss J. Az analis 2000;53(6):263-6.
Iwadare J. Sphincter-preserving techniques for anal fistulas in Japan. Dis Colon Rectum. 2000;43(10 Suppl):S69-77.
Hongo Y, Kurokawa A, Nishi Y. Open coring-out (function- preserving) technique for low fistulas. Dis Colon Rectum. 1997;40(10 Suppl):S104-6.
Sentovich SM. Fibrin glue for anal fistulas: long-term results. Dis Colon Rectum. 2003;46(4):498-502.
Aitola P, Hiltunen KM, Matikainen M. Fibrin glue in perianal fistulas - a pilot study. Ann Chir Gynaecol. 1999;88(2):136-8.
Chan KM, Lau CW, Lai KK, et al. Preliminary results of using a commercial fibrin sealant in the treatment of fistula-in-ano. J R Coll Surg Edinb. 2002;47(1):407-10.
Sonoda T, Hull T, Piedmonte MR, Fazio VW. Outcomes of primary repair of anorectal and rectovaginal fistulas us- ing the endorectal advancement flap. Dis Colon Rectum.
Mizrahi N, Wexner SD, Zmora et al. Endorectal advance- ment flap: are there predictors of failure? Dis Colon Rectum. 2002;45(12):1616-21.
Gustafsson UM, Graf W. Excision of anal fistula with closure of the internal opening: functional and manometric results. Dis Colon Rectum. 2002;45(12):1672-8.
Malouf AJ, Buchanan GN, Carapeti EA, et al. A prospective audit of fistula-in-ano at St. Mark’s hospital. Colorectal Dis. 2002;4(1):13-9.
Theerapol A, So BY, Ngoi SS. Routine use of setons for the treat- ment of anal fistulae. Singapore Med J. 2002;43(6):305-7.
Mohite JD, Gawai RS, Rohondia OS, Bapat RD. Ksharsootra (medicated seton) treatment for fistula-in-ano. Indian J Gastro- enterol. 1997;16(3):96-7.
