AB199. SOH26AB_0077. An evaluation of the treatment of perianal fistulas in Portiuncula University Hospital

Background: Fistula-in-ano is an abnormal channel between the anal canal and the perianal skin. The most common causes of perianal fistulas include perianal abscesses and the presence of Crohn’s disease. Treatment methods include advancement flaps, seton placement, ligation of tracts, fistulotomy, fistulectomy, and/or use of biological agents. The objective of this audit was to assess the treatment of fistula-in-ano with respect to the time to final procedure, number of procedures, and recurrence rates at Portiuncula University Hospital (PUH).

Methods: Patients treated for perianal fistulas between January 2023 and December 2024 were identified from theatre appointment records. Patient Reference Numbers were used to identify patients’ charts, and patient information was coded and anonymised. The extracted data included initial referral dates, date of the first outpatient appointment, procedure dates and details, and discharge status. Microsoft Excel was used to store the data of dates and procedures. Analysis was also conducted using Microsoft Excel.

Results: The initial treatment in all patients involved seton insertion. Fifteen of the twenty patients had received treatment by fistulotomy or fistulectomy. The remaining five patients are still being observed for their exchanges at regular intervals. The average number of procedures prior to fistulotomy or fistulectomy was 2.46. The recurrence rate for further treatment post-fistulotomy or fistulectomy was 13.3%.

Conclusions: The recurrence rate post-fistulotomy or fistulectomy was 13.3% among patients in PUH. The current practice of seton treatment prior to definitive treatment is in line with current guidelines and recommendations.

Keywords: Fistula; fistulectomy; fistulotomy; perianal; treatment