Viso L, Mullerat J
Servicio de Cirugía General, Hospital de la Cruz Roja, Universidad Autónoma de Barcelona.
Rev Esp Enferm Dig. 1990 Sep;78(3):135-7.
Between January, 1986 and December, 1988, 84 patients with anal fistula were operated on. Sixty-six were males and 18 females, with a mean age of 36 years. There was 100% follow-up. Parks' classification (1976) was used, with the following distribution: 65% transsphincteral 23% intersphincteral, 10% subcutaneous and 1% suprasphincteral fistulas. Fistulotomy and flattening were performed in every case but four, in which a seton ligature was used, performing a partial fistulotomy. Goodsall's rule was followed in 96.5% of the cases. The mean length of hospital stay was 2.1 days. Morbidity was 3.5% and the recurrence and gas incontinence rates were 4.7% and 3.5%, respectively. It was concluded that Parks' classification and Goodsall's rule are very useful in fistular surgery and that section of 3/4 of the sphincter does not increase the rate of incontinence, although a seton must be used in 5% of the cases with a 50% failure rate.