Journal of AdvancedMedical and Dental Sciences Research

Aim: To investigate the frequency of individuals with anal fistula resulting from chronic anal fissure. Material and Methods: This study was descriptive observational research done in the surgical department. The patients were checked on the 8th day after surgery, and again at 1, 2, and 6 months after the operation. The objective healing was described as the full epithelization of the fissure base and any raw regions resulting from sentinel pile excision or fistulotomy. Analyzed in the group of patients who had surgery were the time of pain relief and complications. After 6 months, a favorable clinical result was determined by the absence of anal symptoms and the presence of objective healing of the fissure. The Cleveland Clinic Incontinence Score (CCIS) was also recorded at the 6-month mark. Results: Out of the 171 patients who had surgery, 120 (70.2%) had a lateral internal sphincterotomy (LIS) without any extra complications. Two complications (1.7%) were observed. One instance had bleeding that needed further hemostasis, while another person developed an infection on the LIS incision. The pain alleviation time was 1.82±1.02 days. Complete healing was attained in 114 patients (95%) after one month and in 118 patients (98.3%) after two months. At 6 months, three patients were lost to follow-up. The other patients all recovered, except for one who had a recurrence and was successfully treated with a Botox® injection, resulting in a 96.7 percent success rate. Table 1 displays the parameters that were examined. Sentinel heaps were found in 56 patients, representing 22% of the total. Out of the 171 patients who had surgery, 46 individuals (26.9%) developed sentinel piles. 44 patients (95.7%) willingly consented to the removal of sentinel heaps (LIS+sentinel pile excision group). Two patients were eliminated from further analysis. One patient had an abscess and fistula at the sphincterotomy site, while another patient had bleeding at the raw region of the sentinel pile excision, resulting in a complication rate of 4.5 percent. The healing rates at postoperative one, two, and six months were 90.9%, 95.5%, and 95.5%, respectively. These rates showed just a little slower healing rate compared to patients who had LIS surgery (p>0.05 for all comparisons).Conclusion: Ultimately, a minimum of 3 percent of individuals with CAF have a concurrent abscess or fistula around the fissure. Practitioners in this profession, as well as hospitals and insurance companies, must critically evaluate and acknowledge this truth, even if it is sometimes hidden.