[Surgical treatment of anorectal fistulas. A 17-year experience at the Instituto Nacional de la Nutrición "Salvador Zubirán"]. / Tratamiento quirúrgico de las fístulas anorrectales. Experiencia de 17 años en el Instituto Nacional de la Nutrición "Salvador Zubirán".

INTRODUCTION: Surgical treatment for anorectal fistula may be difficult because of the risk of recurrence, prolonged healing or anal incontinence following the operation. OBJECTIVE: To analyze the experience with the surgical management of ano-rectal fistula during a period of 17 years. PATIENTS AND METHODS: The medical records of 105 patients with anorectal fistulas were reviewed retrospectively, with analysis of demographic and clinical data, operative treatment, and results. RESULTS: There were 73% men and 27% women. Mean age was 45 years. 86% had an underlying chronic disease, most frequently diabetes mellitus (21%) and obesity (14%). No anatomic classification of the fistulous tract was done in 86% of cases, and inter-sphincteric tracts were the most frequent type in the classified cases. In 90% of cases, treatment was fistulectomy. Complications occurred in 13% of cases, mainly delayed healing (6.5%). Recurrent disease was documented in 11 cases (10%), and the majority were treated with a new fistulectomy. There were no cases with anal incontinence following the operation. CONCLUSIONS: The necessity of performing the anatomic classification of ano-rectal fistula should be emphasized. Fistulectomy was the most frequent surgical procedure.