Long-term outcome of low perianal fistulas treated by fistulotomy: a multicenter study
| Autor: | T. Lettinga, Laurents P. S. Stassen, K. W. A. Göttgens, H. J. Belgers, Paul T.J. Janssen, F. M. H. van Dielen, Stephanie O. Breukink, J. L. M. Konsten, Jeroen Heemskerk, A. G. M. Hoofwijk |
|---|---|
| Přispěvatelé: | Surgery, RS: NUTRIM - R2 - Gut-liver homeostasis, RS: SHE - R1 - Research (OvO), Biochemie |
| Jazyk: | angličtina |
| Rok vydání: | 2015 |
| Předmět: |
Adult
Male medicine.medical_specialty Time Factors Adolescent Fistula Population Fistulotomy Young Adult Quality of life Recurrence Surveys and Questionnaires medicine Fecal incontinence Humans Rectal Fistula education Child Digestive System Surgical Procedures Aged Proportional Hazards Models Aged 80 and over education.field_of_study Wound Healing business.industry Proportional hazards model Gastroenterology Middle Aged medicine.disease Confidence interval Surgery Treatment Outcome Child Preschool Etiology Quality of Life Female medicine.symptom business Fecal Incontinence |
| Zdroj: | International Journal of Colorectal Disease, 30(2), 213-219. Springer, Cham |
| ISSN: | 0179-1958 |
| Popis: | PURPOSE: Fistulotomy is considered to be the golden standard for the treatment of low perianal fistula but might have more influence on continence status than believed. This study was performed to evaluate the healing rate after a fistulotomy and to show results for continence status. METHODS: A retrospective database study was performed in one university medical center and its six affiliated hospitals. All patients treated with a fistulotomy for a low perianal fistula were identified. Healing and recurrence of the fistula were identified. Questionnaires on continence status and quality of life were mailed to all patients. RESULTS: In total, 537 patients were identified. The primary etiology of the fistulas was cryptoglandular (66.5%). Recurrence was seen in 88 patients (16.4%) resulting in a primary healing rate of 83.6%. After secondary treatment for the recurrence, another 40 patients healed. This resulted in a secondary healing rate of 90.3%. The Kaplan-Meier analysis showed that at 5 years, the healing rate was 0.81 (95% confidence interval (95% CI) 0.71-0.85). The mean Vaizey score was 4.67 (SD 4.80). Major incontinence, defined as a Vaizey score of >6, was seen in 95 (28.0%) patients. Only 26.3% of the patients had a perfect continence status (Vaizey score 0). Quality of life was not different from the general population. CONCLUSIONS: Fistulotomy seems to be associated with a healing rate of 0.81 (95% CI 0.71-0.85) after 5 years. However, major incontinence is still reported by 26.8% of patients and only 26.3% of patients had a perfect continence status. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink