Efficacy of crypto glandular debridement in fistula in ano based on a new classification

Dr Praveen Kumar

Volume : VI, Issue : XII, December - 2016

Efficacy of crypto glandular debridement in fistula in ano based on a new classification

Dr Praveen Kumar

Abstract :

The aim of this study was to evaluate the efficacy of minimal excision and curettage of fistula in ano in reducing morbidity and recurrence. Twenty patients of primary crypto–glandular fistula in ano were selected for the study. Only those patients were included in the study, which had internal opening in posterior midline and limited to superficial post anal space. The cases were diagnosed by clinical examination, MRI fistulogram, biopsy and pus culture. The secondary fistula in ano patients were excluded from the study. The patients were randomly divided in to two groups. Group A (10 patients) was subjected to the conventional fistulotomy and fistulectomy while group B (10 patients) was subjected to the crypto glandular deidement at posterior midline. After the therapy, patients were followed up for a period of six months for evaluation of healing, recurrence and effect on continence. The most accepted classification of fistula has been Park‘s classification. After years of evaluation, it was noticed that complicity of fistula increased with the vertical extension of abscess and based on the findings a new classification of fistula was devised. The management of fistula was planned based on this new classification. The mean duration of treatment in group B was much shorter than of group A. Patients of group B showed significant less time to regain their normal activity on account of much less pain. Overall, patients experienced little or no effect on the continence mechanism in both groups. The recurrence rate was negligible in both groups of patients. The cryptoglandular deidement technique is a better choice in comparison to conventional fistulotomy and fistulectomy as regard to pain, morbidity and duration of healing.