title: Recurrence pattern of fistula-in-ano in a Chinese population.
abstract: OBJECTIVE
  Fistula-in-ano is a common colorectal complaint. Despite of the advancement in preoperative imaging and surgical techniques, recurrence is not uncommon in this disease entity. We aimed to determine the recurrence pattern and predictors of FIA in Chinese population.
  
  
  METHODS
  
  
  
  METHODS
  single regional hospital serving a 300,000 population.
  
  
  METHODS
  A systematic retrospective review of inpatient and follow up records and operation records in patients with diagnosis of fistula-in-ano (ICD code - 565.1) from January 2001 to December 2004 was performed.
  
  
  METHODS
  Surgery for fistula-in-ano.
  
  
  RESULTS
  135 out of 137 Chinese patients received anal fistula operations. 14 patients (10.4%) had high type anal fistulas and 27 patients (20%) had perianal sinus. The most common operation was combined fistulotomy-fistulectomy (78 patients, 57.8%). 18 patients (13.3%) had recurrence with a median time to recurrence of 7.5 months. Six factors including: 1) positive history of perianal abscess, 2) previous perianal operation, 3) complex fistula, 4) perianal sinus, 5) absence of an internal opening, 6) surgical procedure of sinus tract excision were significantly associated with recurrence in univariate analysis. Sinus tract excision was the only independent factor to predict recurrence in logistic regression (p=0.002, 95%CI=1.29-3.27).
  
  
  CONCLUSIONS
  Fistula-in-ano carried a significant risk of recurrence in perianal sinus with sinus tract excision performed. No difference was found between Chinese and Caucasian in recurrence pattern of fistula-in-ano.
authors.affiliation: Department of Surgery, North District Hospital, Sheung Shui, N.T. Hong Kong SAR, China. lamyn@ha.org.hk
authors.forename: Chi-Ming
authors.initials: CM
authors.lastname: Poon
authors.forename: Poon
authors.initials: P
authors.lastname: Chi-Ming
authors.forename: Dennis Chung
authors.initials: DC
authors.lastname: Ng
authors.forename: Dennis Ng
authors.initials: DN
authors.lastname: Chung-Kei
authors.forename: Michael Cheung
authors.initials: MC
authors.lastname: Ho-Yin
authors.forename: Raymond Shiu
authors.initials: RS
authors.lastname: Li
authors.forename: Raymond Li
authors.initials: RL
authors.lastname: Shiu-Ki
authors.forename: Heng-Tat
authors.initials: HT
authors.lastname: Leong
authors.forename: Leong
authors.initials: L
authors.lastname: Heng-Tat
mesh_terms: D000328:Adult; D044466:Asian People / Q000706:statistics & numerical data*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012003:Rectal Fistula / Q000175:diagnosis / Q000208:ethnology* / Q000601:surgery*; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome