ĐẶC ĐIỂM LÂM SÀNG, HÌNH ẢNH HỌC VÀ KẾT QUẢ ĐIỀU TRỊ PHẪU THUẬT RÒ HẬU MÔN PHỨC TẠP

Abstract

Background: Anal fistula is the second most prevalent disease in the anal region, after hemorrhoids. Although anal fistula does not cause mortality, it can last for many months or years and is associated with a great deal of discomfort and a decline in labor productivity. Objectives: To describe the clinical characteristics of complex anal fistulas and evaluate the outcomes of surgical treatment. Materials and methods: A cross-sectional descriptive study on 36 patients diagnosed with anal fistula and indicated for surgery at the Department of General Surgery - Hoang Tuan Soc Trang General Hospital and the Department of General Surgery – Can Tho General Hospital from 2022 to 2023. Results: From August 2022 to April 2023, thirty-six patients with complex anal fistulas underwent surgery, with an average age of 36.8 ± 12.2 years (20-69). The two most prevalent symptoms were perianal swelling and anal discomfort, each accounting for 94.4% of cases. The number of external and internal holes recorded on MRI imaging is mainly 1 hole with the rate of 80.6% and 88.9%, respectively. Evaluation on MRI showed that transsphincter fistula accounted for the majority with the rate of 77.8%, of which the median transsphincter fistula was 52.8% and the high transsphincter fistula was 25%. Surgery had a good and moderate outcome of 78% and 22%, respectively. Conclusions: A comprehensive clinical evaluation coupled with imaging studies not only aides in the diagnosis of complex anal fistulas, but also aids in the determination of the most effective treatment strategy, resulting in high surgical success rates. In the study, the success rate for excellent outcomes was 78% and the success rate for average outcomes was 22%. In addition, the study found that the average age of patients with complex anal fistulas is decreasing in comparison to previous research. However, evaluation requires additional in-depth research with larger sample sizes.