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Fistula-in-ano in infants: Is nonoperative management effective?

 Jung-Tak Oh  ;  Airi Han  ;  Seok Joo Han  ;  Seung Hoon Choi  ;  Eui Ho Hwang 
 JOURNAL OF PEDIATRIC SURGERY, Vol.36(9) : 1367-1369, 2001 
Journal Title
Issue Date
Child ; Child, Preschool ; Digestive System Surgical Procedures/methods ; Fissure in Ano/diagnosis* ; Fissure in Ano/surgery ; Fissure in Ano/therapy* ; Follow-Up Studies ; Humans ; Infant ; Male ; Retrospective Studies ; Risk Assessment ; Secondary Prevention ; Sensitivity and Specificity ; Severity of Illness Index ; Treatment Outcome
Fistula-in-ano ; infant ; fistulotomy
Purpose: Recently, a number of studies have reported positive results from the nonoperative management of fistula-in-ano in infancy, although it has not been of use in all patients. The purpose of this study was to discern the effective treatment methods of fistula-in-ano in infants. Methods: A retrospective review was done of 310 children who required operative management for fistula-in-ano or perianal abscess between January 1991 and July 2000. Eighteen patients displayed an onset of symptoms at less than 1 year of age and a duration of symptoms longer than 12 months. The authors analyzed these patients' medical records. Results: All patients were boys. The mean duration of the symptoms was 26.6 ± 27.5 months. Fourteen patients had shown an onset of symptoms at less than 6 months of age. The longest duration was 10 years. The patients showed conservative periods of over 12 months because their parents did not want them to undergo surgery. The disease in these patients followed 2 patterns. One (6 patients) was an onset of symptoms followed by a silent fistula-in-ano state. The other (12 patients) was an onset of symptoms followed by an intermittent relapse of inflammation. All patients underwent fistulotomy, and none of them had recurrent fistula during the follow-up period. Conclusions: Although the advantages of a nonoperative management of fistula-in-ano in infants include the avoidance of general anesthesia and surgical intervention, the lesions cannot be cured by a period of conservation. Surgical management is more effective in respect to the time factor.
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1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Oh, Jung Tak(오정탁)
Choi, Seung Hoon(최승훈)
Han, Seok Joo(한석주) ORCID logo https://orcid.org/0000-0001-5224-1437
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