ASSESSING CLINICAL FEATURES OF FISTULA IN ANO AMONG PATIENTS IN DEPARTMENT OF SURGERY AT THE REGIONAL INSTITUTE OF MEDICAL SCIENCES IMPHAL- A CROSS-SECTIONAL STUDY

Background: An irregular junction between the anal canal and perianal skin is known as a stula-in-ano, and it usually happens as a result of cryptoglandular infections that cause abscesses. Additionally, it can be connected to diseases including cancer, TB, and Crohn's disease. An estimated 8.6–10 cases per 100,000 persons are reported each year, with a male–to-female ratio of up to 9:1. It may occur as a result of hormones and a male's higher anal sphincter tone. Intermittent discharge is the main symptom, which frequently occurs after a history of pain, oedema, or recurrent abscesses. Fistulas are classied as intersphincteric (45%), transsphincteric (30%), suprasphincteric (20%), and extrasphincteric (5%), in accordance with the Parks classication. If less than 30% of the anal sphincter is damaged, they are considered simple; if more than 30% is affected, or if there are several, they are considered complicatedThe study aimed to assess the clinical presentation of stula-in-ano, evaluate different treatment options, and analyze their outcomes. Method: A cross-sectional study was conducted over two years (August 2018 to July 2020) in the Department of Surgery at the Regional Institute of Medical Sciences (RIMS), Imphal, Manipur. Study included 71 patients. Results: This study found stula-in-ano to be more common in males 57 (80.3%), with the majority of cases in the 30-39 age group. The most frequent symptoms were perianal discharge 60 (84.5%), swelling 47(66.2%), pain 29(40.8%), and fever 3(4.2%). Intersphincteric stulas were the most common 45(63.3%), with 80.3% of cases being low-level and predominantly located posteriorly. Fistulectomy was the most performed procedure 58(81.9%), followed by stulotomy (9.9%), stulectomy with sphincter repair 3(4.2%), and LIFT 3(4.2%).Postoperative complications included wound infection3 (4.2%), recurrence 3(4.2%), and incontinence (2.8%). Conclusion: The study concludes that among the 71 patients with Fistula in ano were studied and above ndings were noted. The results suggest stulotomy and LIFT may offer better outcomes, emphasizing the importance of early diagnosis and appropriate treatment.