Analysis of influencing factors of anal fistula formation after perianal abscess operation with different operation methods
HU Jian-sheng，WANG Wen，SUN Lin-mei
Department of Anorectal, Xi' an Hospital of Traditional Chinese Medicine, Xi' an (710016), China
Abstract:
Objective To investigate the influencing factors of anal fistula formation after perianal abscess surgical treatment with different operation methods. Methods A retrospective study was conducted between January 2019 and January 2020. Clinical data of 298 patients with perianal abscess from the department of Anorectal of Xi' an Hospital of Traditional Chinese Medicine were collected. Univariate and multivariate Logistic regression were used to analyze the related factors of the formation of anal fistula between different surgical methods. Results After 1 year follow-up, the incidence of anal fistula after surgical treatment of perianal abscess was 11.7% (35/298). The incidence of anal fistula in the radical treatment group was significantly lower than that in the drainage group (3.6% vs 26.4%, P<0.05). Univariate analysis found that the history of anal operation, fever, whether to use antibiotics prior to admission, course of disease before admission, abscesses location, scope of abscess, the pre-hospital burst, operation method, pus germiculture results, white blood cell count, neutrophils ratio, fibrinogen, D-dimer, hospitalization days were related to postoperative anal fistula formation.(P<0.05). Multivariate Logistic regression analysis showed that previous perianal surgery (OR=2.404, 95%CI: 1.047-5.522, P=0.039), use of antibiotics before admission (OR=2.381, 95%CI: 1.090-5.204, P=0.030) was a risk factor of anal fistula after perianal abscess surgery, and surgical method (Primary radical resection) was a protective factor (OR=0.125, 95%CI: 0.052-0.304, P<0.01). Conclusion The patients with a history of perianal surgery and antibiotics before admission were more likely to form anal fistula after perianal abscess. Primary radical resection had lower incidence of postoperative anal fistula than drainage.
