Comparative Review of Perianal Sinus & Fistula in Ano

ABSTRACT

PURPOSE: A fistula in ano is a granulating track between the anorectum and the perianal region or perineum. A typical fistula may consist of the track, the primary (internal) opening and secondary (external) opening. Its hallmark is frequent discharge through external opening. Sometimes this track become occluded and a sinus remains. Therefore abscence of an external opening should not be taken as evidence that there is no fistula, and then this study is aimed to make clear perianal sinus as another form of fistula in ano. METHODS: This study is a clinical analysis of 17 patients with perianal sinus, who were treated at the Department of General Surgery of Pundang-CHA hospital from June, 1995 to December, 1998. As comparative group, 91 patients of typical fistula in ano were also taken in same period. RESULTS: The ratio of male to female was 4.6:1 in sinus group, 4.1:1 in fistula group. The prevalent ages were in the third decade in both group. The main symptoms of sinus group were a palpable mass (94.1%), pain & discomfort (35.3%) but that of fistula group were purulent discharge (87.9%) and pain (28.6%). The most frequent duration of illness was 6 months~1 year (52.9%) in sinus group, within 6 months (40.7%) in fistula group. The distributions of sinus size were 7 cases (41.2%) in 2 cm. The most common type was intersphincteric in both group. The operative procedures included excision with fistulectomy in 4 cases (23.5%), lay open of sinus with fistulotomy in 11 cases (64.7%), seton procedure in 2 cases (11.8%). The mean hospital stay was 5.0 day in sinus group, 4.9 day in fistula group. CONCLUSIONS: There was no distinct difference in the clinical features or characteristics between the both groups, therefore perianal sinuscould be taken as fistula in ano and treated similar procedures.