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Experience with the surgical management of perianal fistulas in a tertiary care hospital in Puebla
Experience with the surgical management of perianal fistulas in a tertiary care hospital in Puebla
Isaac A. Soto-Patiño 1 
, Carlos A. López-Bernal 2 , Fernando Solís-Calixto 3 , Angélica Porras-Juárez 4 , Nancy R. Bertado-Ramírez 4 , Arturo García-Galicia 5 , Álvaro J. Montiel-Jarquín 4 , Jorge Loría-Castellanos 6 , Sandra Maldonado-Castañeda 7
1 Servicio de Cirugía General, Hospital de Especialidades Puebla Manuel Ávila Camacho, Instituto Mexicano del Seguro Social (IMSS), Puebla, Pue., México; 2 Departamento de Cirugía General, Hospital de Especialidades de Puebla, Instituto Mexicano del Seguro Social (IMSS), Puebla, Puebla, México; 3 Departamento de Coloproctología, Centro Médico Nacional General de División Manuel Ávila Camacho, Hospital de Especialidades de Puebla, Instituto Mexicano del Seguro Social, H. Puebla de Zaragoza, Puebla, Mexico; 4 Dirección de Educación e Investigación enSalud, Hospital de Especialidades de Puebla, Instituto Mexicano del Seguro Social, Puebla, Puebla, México; 5 Dirección de Educación e Investigación en Salud, Hospital de Especialidades de Puebla, Instituto Mexicano del Seguro Social (IMSS) Puebla, México; 6 Red Nacional de Educadores en Simulación Clínica, Ciudad de México. México; 7 Modelo de Atención a la Salud para el Bienestar, IMSS Bienestar, Puebla, Pue., México
*Correspondence: Álvaro J. Montiel-Jarquín. Email: dralmoja@hotmail.com
Abstract
Background: Anal fistula is a common pathology characterized by an abnormal communication between the anorectal canal and the perianal skin, usually resulting from a chronic infection. Surgical intervention, aimed at eradicating the infection, preventing recurrence, and preserving sphincter function, is essential.
Objective: To evaluate the surgical management of anal fistulas in a tertiary care hospital, in order to standardize treatment protocols and improve surgical outcomes.
Material and methods: An observational, cross-sectional, retrospective, and unicentric study conducted between March 2021 and March 2024, in the general surgery department. A total of 217 patients with a diagnosis of anal fistula were included, excluding patients with malignant neoplasms and incomplete records. The variables included sex, age, body mass index, type of surgical treatment, and postoperative complications. Data were analyzed using SPSS 25. Correlation between variables was sought using Spearman’s statistic, considering a p-value ≤ 0.01 as statistically significant.
Results: Most of the patients were men (50.2%), with an average age of 41 years. The most frequent etiology was cryptoglandular infection (93.1%), and the most common type of fistula was simple (94.5%). No patient presented post-surgical complications. The average days of disability was 23 days.
Conclusions: The study demonstrates that the surgical treatment of simple fistulas, using techniques such as fistulotomy, has good results with a low complication rate and rapid recovery. However, complex fistulas remain a challenge and require a multidisciplinary approach.
Keywords: Perianal fistulas. Surgical correction. Effectiveness.
