Anal fistulas situated anteriorly in the female.

概要

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The anal fistulas situated anteriorly in the female has been notorious for its liability to postoperative sphincteric insufficiency caused by the thin and coarse formation of the sphincters in this area. Forty six cases of them were analysed here to illustrate the characteristics (excluded are cases with Crohn's disease). The age distribution shows the peak is at thirties. As for the types, simple, low intersphincteric fistula is predominant, although there are a few complicated cases such as a high, high and low intersphincteric fistula, an ischiorectal and a pelvirectal fistula case. There is no extremely complicated case nor a case with perforation to the vagina. The length of ailment ranges from fairly short time of days to long time of years. The operational methods are open in 24% and sphincter-preserving in 76%. Our method of sphincter-preserving consists of coring out with complete preservation of the sphincters. The incidence of postoperative complication is minimal, the term of hospitalization is 25days in average and the term of complete healing is within 40days in most cases. The recurrence was observed in 6, all of which are reoperated and healed well except one case. The other characteristic is existence of cases with the primary opening between the dentate line and anal verge, of which macroscopic and microscopic pathology are reported.