Short Form 36 quality of life after lay open of anal fistula

Abstract

Background Fistulotomy is a standard procedure in the treatment of anal fistula. Most reports on fistulotomy focus on the clinical outcome of surgery with only few studies examining the impact of fistula surgery on patient's quality of life (QOL). The aim of the present study was to examine the effect of fistulotomy on patient's QOL. Patients and methods A total of 169 patients, who had lay open for perianal fistula at Ain Shams University Hospitals during the period from January 2011 to June 2013, were contacted at least 1 year after surgery, and were asked to fill up the Short Form 36 (SF36) QOL questionnaire. The patients' SF36 scores were compared with those of the US norms. Results The patients who were cured of their fistula ( n = 106, 62.7%) were significantly better than the US norms in the domains of physical functioning, bodily pain, vitality and physical role limitation, whereas the US norms were significantly better in mental health (MH). The US norms were significantly better than patients who developed fistula recurrence ( n = 6, 3.5%) in MH and social functioning. The US norms were significantly better than fistula patients who developed postoperative incontinence ( n = 53, 31.3%) in the domains of general health perception, vitality, social functioning and MH; the difference in other domains was not significant. The US norms were significantly better than patients who developed minor postoperative symptoms other than incontinence and recurrence ( n = 31, 18.3%) in general health perception and MH, whereas no significant difference was found in other domains. All groups of patients either did not show significant difference or were significantly better than the US norms in the domain of physical role limitation. Conclusion The majority of patients have a good QOL after fistulotomy. Recurrence, stool incontinence and the development of other postoperative symptoms can negatively affect some domains of QOL. Solid stool incontinence has the worst effect on QOL. The least affected QOL domain is the physical role limitation.