Recurrence after Fistula in Ano surgery and its associated factors at Tikur Anbessa Specialized Hospitaland Zewditu Memorial Hospital in Addis Ababa,Ethiopia :a Two Year retrospective medical record review study From July 1,2022-June 30,2024.
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Date
2025-07
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Addis Ababa University
Abstract
Background: Fistula-in Ano (FIA) is a benign disease and its surgical management is still challenging since antiquity. Recurrence and persistent of fistula continue to frustrate both patients and treating physicians and it affects quality of life of patients. The main objective of this study was to determine the overall recurrence rate after FIA surgery and to identify factors associated with it at Tikur Anbessa Specialized Hospital (TASH) and Zewditu Memorial Hospital (ZMH) in Addis Ababa, Ethiopia.
Method and Materials: We conducted a Retrospective medical record review of patients after surgery in two hospitals (TASH and ZMH) from July 1,2022-June 31,2024 the patient’s medical record in electronic forms and hard copy of the medical record was reviewed to collect the variables (with a well-structured check-lists), the missed information was collected through phone calls. Data was entered to SPSS version 25. Descriptive statistics was performed to characterize socio- demographics, characters of fistula, procedure types, surgical outcomes. Bivariable and multivariable logistic regression was performed to determine the factors that affect the rate of recurrence. Adjusted odds ratio (AOR) with 95% confidence interval (CI) was used to assess strength of associations and p-value≤0.05 was taken as significance to determine factors affecting recurrence.
Results: From the total 170 patients included in this study 138 were males and 38 years of median age (range 18-79 years) and median follow of 11 months (range 6-24 months. Thirteen (7.7 %) of patients had recurrence and 12(7.1%) patients had presentence of fistulas. Comorbidity significantly increased the odds of having persistence of FIA after surgery (AOR 31.786 ;95% CI 1.924 352.630; p value=0.005) whereas patients who had non sphincteric sparing procedure were protective form developing persistence of FIA by 84.5% (AOR 0.155;95% CI 84.7 %); p value= 0.050) but no predictors found to affect the recurrence rate on multi variable logistic regression.
Conclusions: Recurrence and persistence of the FIA were 7.7 and 7.1 respectively in our study. Comorbidities increased the persistence of the FIA but non-sphincteric sparing surgical procedure prevents it. No significant predictors were found for the recurrence after FIA surgery. Strategies that optimize preoperative patient selection, addressing the medical comorbidities and tailor procedure choice to fistula anatomy my reduce the persistence of fistula and recurrence.
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Fistula-in Ano