DOI: https://doi.org/10.36347/sasjs.2025.v11i02.006

Pages: 138-144

Background: Fistulotomy is a widely performed surgical procedure for the management of anal fistulas. While it is considered effective; complications, healing time, and recurrence rates vary. This study aimed to evaluate the outcomes of fistulotomy, focusing on post-operative complications, healing duration, and recurrence rates. Methods: This prospective observational study included 350 patients who underwent fistulotomy across six hospitals in Bangladesh from July 2021 to June 2024. Demographic, clinical, and surgical data were collected using a structured data sheet and outcomes were analyzed. Outcomes assessed included complications (e.g. incontinence, infection, bleeding), wound healing time, recurrence within six months, and patient satisfaction. Results: The majority of patients (84.9%) were male, with a mean age of 39.3 ± 12.1 years. The most common fistula type was intersphincteric (60.9%), and 81.7% were classified as simple fistula. Post-operative complications included temporary flatus incontinence in 7.4%, reactionary hemorrhage in 7% of cases, with no significant infective complications. Cumulative 77.7 % patients experienced complete healing within sixty days, and the recurrence rate was 7.7%. Patient satisfaction was high, with 85.1% of patients expressing satisfaction with the outcomes. The median time for returning to daily activities was 2.3 days, and hospital stays were short (median: 1.2 days). Conclusion: Fistulotomy remains an effective treatment for anal fistulas, with low complication and recurrence rates. Most patients experienced favorable healing times and high satisfaction levels, reaffirming fistulotomy as a reliable surgical approach.