title: Successful treatment of horseshoe fistula requires deroofing of deep postanal space.
abstract: A total of 24 patients underwent treatment for horseshoe fistula-in-ano. In 3 patients the disease was bilateral; in 21 unilateral. Treatment consisted of deroofing the postanal space with division of overlying external sphincter muscle by seton. In 22 cases (92%), lateral wings were deroofed. At 23 months (range: 5 to 45 months), 23 cases (96%) have healed. Five (21%) have required reoperation: one remains unhealed. Mean healing time was 3.5 months (1 to 13). Five patients wear a protective pad, but 14 (64%) consider their continence normal. A total of 13 patients consider their result excellent, 9 good, 1 fair, and 1 a failure. Good to excellent results of treatment of horseshoe fistula and complete healing may be achieved in 92% of cases by a method that includes deroofing the deep postanal space and lateral wings.
authors.affiliation: Department of Surgery, University of British Columbia, Vancouver, Canada.
authors.forename: M E
authors.initials: ME
authors.lastname: Pezim
mesh_terms: D000038:Abscess / Q000150:complications; D000328:Adult; D000368:Aged; D001004:Anus Diseases / Q000150:complications; D005242:Fecal Incontinence / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012003:Rectal Fistula / Q000209:etiology / Q000601:surgery*; D013514:Surgical Procedures, Operative / Q000379:methods; D016896:Treatment Outcome