Title : Effect of clinical characteristics and treatment of perianal abscess on postoperative recurrence or anal fistula formation
Abstract:
Objective: To investigate the clinical characteristics, diagnosis and treatment of perianal abscess and its effect on postoperative recurrence or anal fistula.
Methods: Clinical data of patients with perianal abscess diagnosed in our hospital and undergoing surgical treatment from January 2020 to January 2023 were collected for retrospective analysis, and outpatient or telephone follow-up was maintained after surgery until January 2024 to evaluate the recovery of patients within 1 year after surgery. According to whether anal fistula recurred or formed within 1 year after surgery, the patients were divided into poor and good prognosis group. The clinical data of the two groups were compared, including age, gender, preoperative blood routine, combined underlying diseases, abscess cavity scope and surgical method (abscess incision and drainage under epidural anesthesia or abscess incision and treatment), and Wexner score was used to evaluate the recovery of anal function of the patients. Logistic regression was used to analyze the risk factors affecting the prognosis of perianal abscess.
Results: A total of 125 patients were collected, including 21 patients with poor prognosis (16.8%) and 104 patients with good prognosis (83.2%). There was no significant difference between the two groups in gender, age, diabetes mellitus or not. There were significant differences between the two groups in preoperative MRI examination, surgical method, preoperative blood routine, pus space range and anatomical classification. The incidence of abnormal preoperative blood routine (χ2=5.90, P=0.02), high abscess space rate (χ2=3.93, P=0.05) and perianal subcutaneous ulcer (χ2=4.49, P=0.03) in the poor prognosis group was higher than that in the good prognosis group, and the proportion of preoperative MRI examination (χ2=5.46, P=0.02) was lower than that in the good prognosis group. Logistic regression analysis showed that the range of abscess space (OR=2.018,95%CI: 1.231-3.256) and surgical method (OR=2.209, 95%CI: 1.318-3.586) were independent factors affecting the postoperative cure of perianal abscess.
Conclusion: Detecting the range of abscess space before operation and selecting the appropriate surgical treatment is helpful for the healing of perianal abscess after operation.
Keywords: perianal abscess; anal fistula formation; postoperative recurrence; influencing factor
