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Authors
Abstract(s)
Introdução: A fístula perianal consiste numa comunicação anómala entre o canal
anorretal e a pele da região perianal. É uma condição mais frequente na terceira ou
quarta décadas de vida, acometendo mais homens do que mulheres, na proporção de
2-3:1. A evolução natural da fístula perianal para um abcesso crónico ou para fístula
complexa exige um correto diagnóstico e uma intervenção adequada, eficaz e num
único tempo. O objetivo deste trabalho consistiu em avaliar as técnicas cirúrgicas, os
outcomes e as complicações do tratamento cirúrgico da fístula perianal.
Materiais e Métodos: Estudo transversal e retrospetivo que incluiu indivíduos
com idade igual ou superior a 18 anos, submetidos a tratamento cirúrgico da fístula
perianal no Serviço de Cirurgia Geral da Unidade Local de Saúde de Castelo Branco
no período decorrido entre janeiro de 2017 e dezembro de 2021, através da análise
de processos clínicos. A análise estatística foi realizada através do Statistical
Package for the Social Sciences (SPSS), versão 25.
Resultados: Foram incluídos 78 doentes tratados cirurgicamente por fístula
perianal. O tratamento realizado foi fistulotomia em 56,4% e fistulotomia com
sedânio em 17,9%. Foram adotadas as técnicas de LIFT em 7,7% e retalho de avanço
endorretal em 1,3% dos doentes. Foram registados 14,1% e 11,5% de recidiva e
necessidade de re-intervenção cirúrgica, respetivamente.
Conclusão: As fístulas perianais constituem uma patologia complexa e desafiadora
quer no seu diagnóstico, quer no seu tratamento. A abordagem cirúrgica mais
adotada neste trabalho foi a fistulotomia. As elevadas taxas de recidiva e reintervenção cirúrgica evidenciadas demonstram que, apesar dos avanços na
abordagem das fístulas perianais, ainda são necessários mais estudos para se
compreender esta patologia.
Introduction: The perianal fistula is an abnormal communication between the anorectal canal and the skin of the perianal region. It is a condition that is more common in the third or fourth decades of life, affecting more men than women in a ratio of 2-3:1. The natural progression of perianal fistula to a chronic abscess or complex fistula requires accurate diagnosis and timely intervention. The objective of this study was to evaluate the surgical techniques , outcomes, and complications of surgical treatment for perianal fistula. Methods and Materials: This is a cross-sectional and retrospective study that included individuals aged 18 years or older who underwent surgical treatment for perianal fistula at the General Surgery Service of the Castelo Branco Local Health Unit between January 2017 and December 2021, through the analysis of clinical records. Statistical analysis was performed using the Statistical Package for the Social Sciences (SPSS), version 25. Results: 78 patients surgically treated for perianal fistula were included. The treatment performed was fistulotomy in 56.4% and fistulotomy with seton placement in 17.9%. LIFT techniques were adopted in 7.7% and endorectal advancement flap in 1.3% of patients. Recurrence and the need for surgical reintervention were recorded in 14.1% and 11.5% of patients, respectively. Conclusion: Perianal fistulas are a complex and challenging pathology both in terms of diagnosis and treatment. The surgical approach most commonly adopted in this study was fistulotomy. The high rates of recurrence and the need for further surgical intervention highlight that, despite advances in the management of perianal fistulas, further studies are needed to better understand this condition.
Introduction: The perianal fistula is an abnormal communication between the anorectal canal and the skin of the perianal region. It is a condition that is more common in the third or fourth decades of life, affecting more men than women in a ratio of 2-3:1. The natural progression of perianal fistula to a chronic abscess or complex fistula requires accurate diagnosis and timely intervention. The objective of this study was to evaluate the surgical techniques , outcomes, and complications of surgical treatment for perianal fistula. Methods and Materials: This is a cross-sectional and retrospective study that included individuals aged 18 years or older who underwent surgical treatment for perianal fistula at the General Surgery Service of the Castelo Branco Local Health Unit between January 2017 and December 2021, through the analysis of clinical records. Statistical analysis was performed using the Statistical Package for the Social Sciences (SPSS), version 25. Results: 78 patients surgically treated for perianal fistula were included. The treatment performed was fistulotomy in 56.4% and fistulotomy with seton placement in 17.9%. LIFT techniques were adopted in 7.7% and endorectal advancement flap in 1.3% of patients. Recurrence and the need for surgical reintervention were recorded in 14.1% and 11.5% of patients, respectively. Conclusion: Perianal fistulas are a complex and challenging pathology both in terms of diagnosis and treatment. The surgical approach most commonly adopted in this study was fistulotomy. The high rates of recurrence and the need for further surgical intervention highlight that, despite advances in the management of perianal fistulas, further studies are needed to better understand this condition.
Description
Keywords
Cirurgia Complicações Fístula Perianal Outcomes Re-Intervenção Recidiva Tratamento