FUNCTIONAL OUTCOME OF FISTULECTOMY WITH PRIMARY REPAIR OF SPHINCTER IN TREATMENT OF COMPLEX FISTULA IN ANO

Objective: Afistula in ano is a common surgical issue encountered all over the world. There are multiple treatment options, especially in transphincteric fistulas, creating dilemma in choosing the best. However, fistulectomy is a time-tested treatment with a low recurrence rate, but stool incontinence due to anal sphincter injury is the two most severe side effects of treating anal fistulas. The objective of the study was to evaluate the surgical outcome of “fistulectomy with primary repair” for the treatment of complex fistula in ano involving anal sphincter. Methods: The prospective observational study was conducted including 43 patients undergoing fistulectomy with primary repair of sphincter for fistula in ano. The following outcomes were evaluated on follow-up: Incontinence, recurrence, pain, bleeding, wound dimension, healing time, and length of hospital stay. Results: In the present study, it was observed that fecal incontinence was present in none of the patients in the post-operative period while 4 patients (9%) had mild flatus incontinence. Only one patient had a recurrence of fistula at post-operative day 180. Conclusion: For the treatment of complex anal fistulas, Fistulectomy with Primary Repair of Sphincter is a safe and efficient procedure that has a promising success rate and also has minimal impact on continence