Abstract
The outcome of fistulotomy for anal fistula at 1 year: a prospective multicentre French study. Abramowitz L, Soudan D, Souffran M, Bouchard D, Castinel A, Suduca JM, Staumont G, Devulder F, Pigot F, Ganansia R, Varastet M and for the Groupe de Recherche en Proctologie de la Société Nationale Fran?aise de Colo-Proctologie and the Club de Réflexion des Cabinets et Groupe d'Hépato-Gastroentérologie. 1 In this study Abramowitz et al. have evaluated the outcomes of one stage (for low transphincteric) and two stage (for high transphincteric) fistulotomy for a year after surgery. They found that fistulotomy was associated with low recurrence rates and an improved quality of life compared to life with the fistula. In patients who required two stage fistulotomy a mild continence disturbance was found. Of note, nearly all patients would choose to undergo the surgery again. These results demonstrate again that from a patient's perspective eradication of sepsis and discomfort is more important than a small disturbance in continence. A lesson we sometimes forget when perusing sphincter saving techniques associated with modest long term healing rates.
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