Prognostic value of endoanal ultrasound for fistula-in-ano: a retrospective analysis.
OBJECTIVE
This study was designed to assess whether preoperative endoanal ultrasound plays a prognostic role in the surgical outcome of anal fistula.


METHODS
A retrospective review was conducted at a single institution.


RESULTS
Sixty-nine patients underwent 83 studies. Indications for endoanal ultrasound included complex fistulas and tracts, multiple external openings, recurrent fistulas, and/or failed previous surgical intervention. Mean age was 51.7 years. Fifty-three patients (77 percent) were men. Mean duration of symptoms was 3.1 years. Forty-nine patients (71 percent) had undergone previous surgical intervention to eradicate sepsis or fistula. Sixty patients (87 percent) underwent surgical interventions and were divided into two groups: Group A (73.3 percent), concordance with ultrasound findings; and Group B (26.7 percent), nonconcordance. Mean follow-up in the surgical group was 15.6 months. Measured outcome was total number of operations per patient and failure rate of primary surgical intervention. No difference was noted in mean total number of operations between Group A (1.57) and Group B (1.69) (P = 0.71). There was a statistically nonsignificant trend toward a higher failure rate of the primary intervention in the nonconcordance group [failure rate 18.2 percent in Group A vs. 25 percent in Group B (P = 0.72)].


CONCLUSIONS
The findings and accuracy of preoperative endoanal ultrasound did not influence postoperative outcome.
Weisman
Nicholas
N
Colon and Rectal Surgery, Department of Surgery, Kaiser Permanente, 4760 Sunset Boulevard, Los Angeles, California 90027, California.
Abbas
Maher A
MA
D000328:Adult; D001003:Anal Canal / Q000000981:diagnostic imaging / Q000601:surgery; D013505:Digestive System Surgical Procedures / Q000379:methods; D019160:Endosonography / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care / Q000379:methods; D011379:Prognosis; D012003:Rectal Fistula / Q000000981:diagnostic imaging* / Q000601:surgery; D012008:Recurrence; D012189:Retrospective Studies; D012720:Severity of Illness Index