Results of treatment of fistula-in-ano

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Abstract
To evaluate the application of Parks'' classification in the management of patients with fistula-in-ano, a study was undertaken to assess the outcome of surgery, especially with respect to the recurrence rate and alteration of continence. A retrospective analysis of 160 consecutive patients who were classified at the time of operation was conducted. The distribution of fistulas was as follows: intersphincteric, 41.9%; transsphincteric, 52.1%, suprasphincteric, 1.3%; extrasphincteric, 0. A horseshoe extension occurred in 8.8% of the fistulas and 3.8% did not exactly conform to the classification as they were either complex or combinations of more than 1 type of fistula. The sole immediate postoperative complication was bleeding, which occurred 1 wk postoperatively and ceased spontaneously (0.7%). Alteration in continence occurred in 6% of patients with 2.6% experiencing temporary incontinence to flatus, 1.3% to liquid stool and 0.7% to solid stool. Permanent loss of control for flatus occurred in 1 patient (0.7%). No patients suffered loss of control for solid stool. Recurrence developed in 6.3% of patients, all between 5-25 mo. postoperatively. Classification was found to be a useful guide in the operative management of patients with fistula-in-ano.

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