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2004, Number 2

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Cir Gen 2004; 26 (2)

Surgical treatment of perianal abscesses: initially, only drainage?

Oliver GI, Fernández FA, Lacueva GJ, Costa ND, Calpena RR

Language: Spanish
References: 14
Page: 107-109
PDF size: 45.10 Kb.


ABSTRACT

Objective: To assess the efficacy of two surgical treatments for perianal abscesses: simple drainage and drainage plus treatment of the fistulous tract in one surgical time.
Setting: University General Hospital of Elche, Spain.
Design: Retrospective study.
Statistical analysis: Pearson’s chi square test was used to compare the independence hypothesis contrast between type of treatment and hospital stay, recurrence, and continence. Statistical significance was set at p‹0.05.
Patients and methods: Group A included patients treated simultaneously for the abscess and the fistulous tract (n = 137), and Group B corresponded to those patients treated only for the abscess (n = 183) – In 23 patients, assigned initially to group A, only simple drainage of the abscess could be performed because the internal orifice of the fistula could not be localized.
Results: When only the abscess was drained, 71% of patients were discharged during the first 24 hours (p‹0.001). Whereas group A presented 2% of recurrences, in group B these increased up to 20% during the year of follow-up (p‹0.001). Likewise, the largest rates of incontinence were observed in those patients treated simultaneously for the abscess and the fistulous tract (p‹0.001).
Conclusion: If the internal orifice is not localized or a large part of the sphincter is affected, it is preferable to drain only the abscess and treat the fistulous tract in a second surgical time.


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