Outcomes of Management of Anal and Perianal Suppuration at Niamey National Hospital, Niger
Journal of Surgery
Volume 6, Issue 4, August 2018, Pages: 101-106
Received: Jul. 9, 2018; Accepted: Jul. 19, 2018; Published: Aug. 14, 2018
Views 885      Downloads 54
Authors
Rachid Sani, Department of General and Digestive Surgery, Niamey National Hospital, Faculty of Health Sciences, Abdou Moumouni University of Niamey, Niamey, Niger
Harissou Adamou, Department of General and Digestive Surgery, Zinder National Hospital, Faculty of Health Sciences, University of Zinder, Zinder, Niger
Lassey Didier James, Department of General and Digestive Surgery, Niamey National Hospital, Faculty of Health Sciences, Abdou Moumouni University of Niamey, Niamey, Niger
Ibrahim Amadou Magagi, Department of General and Digestive Surgery, Zinder National Hospital, Faculty of Health Sciences, University of Zinder, Zinder, Niger
Younssa Hama, Department of General and Digestive Surgery, Niamey National Hospital, Faculty of Health Sciences, Abdou Moumouni University of Niamey, Niamey, Niger
Adama Saidou, Department of General and Digestive Surgery, Niamey National Hospital, Faculty of Health Sciences, Abdou Moumouni University of Niamey, Niamey, Niger
Kadi Idé, Department of General and Digestive Surgery, Niamey National Hospital, Faculty of Health Sciences, Abdou Moumouni University of Niamey, Niamey, Niger
Illa Hamidine, Department of General and Digestive Surgery, Zinder National Hospital, Faculty of Health Sciences, University of Zinder, Zinder, Niger
Hadjara Dady, Department of Anaesthesia and Critical Care, Niamey National Hospital, Faculty of Health Sciences, Abdou Moumouni University of Niamey, Niamey, Niger
Maman Sani Chaibou, Department of Anaesthesia and Critical Care, Niamey National Hospital, Faculty of Health Sciences, Abdou Moumouni University of Niamey, Niamey, Niger
Article Tools
Follow on us
Abstract
Bakground: Anal and perianal sepsis is common anorectal disorders found in surgical practice. This study aims to report epidemiological aspects and outcomes of management of anal and perianal suppuration. Methods: This was a retrospective study from January 2011 to June 2016 at Niamey National Hospital. Patients operated on for anal and perianal suppuration of non-specific anorectal origin were included. Results: During the study period, we collected 141 cases of anal and perianal suppurations. The average age of our patients was 42±8.8 years. The sex ratio was 3.27 in favor of men. The origin of the patients was urban in 73.8% of the cases. The history of diabetes mellitus was found in 14.2% (n=20). Anal fistulas and anal abscesses (n=115) were simple in 46% (n=53) and complex in 54% (n=62). A fistulectomy with the placement of an elastic seton was performed for 41.13% of cases (n=58) and fistulotomy in 29.78%. The evolution of 6 months was marked by a recurrence in 10.63% (n = 15), the anal incontinence of gas at 9.21% (n=13). Deaths (n=4) were recorded in patients with Fournier’s gangrene. Uncomplicated therapeutic success was 80.13% (n=113). Conclusion: The surgical treatment of anal fistula (the main cause of anal and perianal suppuration) aims to eradicate the suppuration and to preserve the anal continence. The fistulotomy done in the context of the management of a simple fistula gives a better outcome. Incontinence-related complications and relapses must impose thoroughness and patience in the surgical treatment of complex fistulas.
Keywords
Anal Fistula, Perianal, Abscesses, Cryptoglandular, Fistulectomy, Fistulotomy
To cite this article
Rachid Sani, Harissou Adamou, Lassey Didier James, Ibrahim Amadou Magagi, Younssa Hama, Adama Saidou, Kadi Idé, Illa Hamidine, Hadjara Dady, Maman Sani Chaibou, Outcomes of Management of Anal and Perianal Suppuration at Niamey National Hospital, Niger, Journal of Surgery. Vol. 6, No. 4, 2018, pp. 101-106. doi: 10.11648/j.js.20180604.15
Copyright
Copyright © 2018 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
References
[1]
Ommer A, Herold A, Berg E, Furst A, Post S, Ruppert R, et al (2017). German S3 guidelines: anal abscess and fistula (second revised version). Langenbecks Arch Surg; 402 (2):191-201. doi: 10.1007/s00423-017-1563-z.
[2]
Sugrue J, Nordenstam J, Abcarian H, Bartholomew A, Schwartz JL, Mellgren A, Tozer PJ (2017).. Pathogenesis and persistence of cryptoglandular anal fistula: a systematic review. Tech Coloproctol. 21 (6):425-432.
[3]
de Parades V, Zeitoun JD, Atienza P (2010). La fistule anale cryptoglandulaire. J Chir Visc 147 (4):265–277.
[4]
Zeitoun JD, de Parades V (2016). Abcès anal: lors de l’intervention de drainage, faut-il chercher et traiter la fistule ? Colon Rectum; 10 (1):76-79.
[5]
Abramowitz L, Allez M, Devulder F, Faucheron JL, Ganansia R, Soudan D, Tarrerias AL (2010). In: Fistules anales. La «Collection SNFCP». Springer, Paris 2010; 103 pages. https://doi.org/10.1007/978-2-8178-0019-6_4.
[6]
Wright WF (2016). Infectious Diseases Perspective of Anorectal Abscess and Fistula-in-ano Disease. Am J Med Sci; 351 (4):427-34.
[7]
Fathallah N, Ravaux A, de Parades V, Pommaret E, Crochet E, Ganansia O (2017). Conduite à tenir face à un abcès anopérinéal. Ann. Fr. Med. Urgence; 7:174-182.
[8]
Pigot F (2015). Traitement des fistules anales abcédées ou non. J Chir Visc, 152 (2): S22-S28.
[9]
Amato A, Bottini C, De Nardi P, Giamundo P, Lauretta A, Realis Luc A et al (2015). Evaluation and management of perianal abscess and anal fistula: a consensus statement developed by the Italian Society of Colorectal Surgery (SICCR). Tech Coloproctol; 19 (10):595–606.
[10]
Neto I. J F C, Wercka J, Rangel DP, Lopes EA., Watté HH, Souza RFL et al (2017). Retrospective analysis of patients submitted to surgical treatment of perianal fistula in Santa Marcelina Hospital, São Paulo. J coloproctol; 37 (3), 193-198.
[11]
Arnous J, Denis J, & Puy-Montbrun T (1980). Les suppurations anales et périanales. À propos de 6500 cas. Concours Med, 12, 1715-29.
[12]
Parks AG; Gordon PH, Hard Castle JD (1976). Classification of fistula in ano Br. J Surg; 63:1-12.
[13]
Hasbi, S (2017). Traitement chirurgical des fistules anales cryptoglandulaires. Étude rétrospective chez 64 patients. J Afr Hepato Gastroenterol (2017) 11 (4): 152-154.
[14]
Bagny A, Lawson-Ananissoh, LM., Bouglouga O, El Hadji YR., Kaaga LY, Redah, D, Djibril, MA (2017). La pathologie anorectale au chu campus de Lomé (Togo). Eur Sci Journal- ESJ; 13 (3): 423-248.
[15]
Kouadio GK, Kouadio LN, Turquln HT (2015). Prise en charge de la fistule anale au CHU de Treichville à Abidjan. A propos de 47 observations. Rev. CAMES - Série A, Sciences et Médecine; A-2: 45-47.
[16]
Mathusoothanan, P., & Venugopal, ER. A (2018). Clinical Study on Perianal Abscess. Stanley Medical Journal; 4 (4), 6-8.
[17]
Sissoko F, Ongoiba N, Coulibaly Y, Coulibaly B, Doumbia D, Dembélé M, et al (2003): Fistules anales à l’hôpital du point G à propos de 164 cas. Mali Méd; 18 (1&2): 25-28.
[18]
Bakari AA, Ali N, Gadam IA, Gali BM, Tahir C, Yawe K, et al (2013). Fistula-in-Ano Complicated by Fournier’s Gangrene Our Experience in North-Eastern Region of Nigeria. Niger J Surg. 2013; 19 (2):56-60.
[19]
Oueidat D, Assi TB, Youssef L, Rizkallah A., Zerbe R, Cappello F et al (2015). A 30 year experience in the management of anal fistula. Euromediterranean Biomedical Journal, 12 (39) 184–188.
[20]
Siproudhis L (2015). Fistules anales: deux doigts de prudence et un doigt d’expertise! Hépato-Gastro & Oncologie Digestive; 22 (9):837-9.
[21]
Khati NJ, Sondel Lewis N, Frazier AA, Obias V, Zeman RK, Hill MC (2013). CT of acute perianal abscesses and infected fistulae: a pictorial essay. Emerg Radiol.; 2 (3):329-35.
[22]
Joy HA, Williams JG (2002). The outcome of surgery for complex anal fistula. Colorectal Dis.; 4 (4):254-261.
[23]
Garg P (2018). Understanding and Treating Supralevator Fistula-in-Ano: MRI Analysis of 51 Cases and a Review of Literature. Dis Colon Rectum; 61 (5):612-621. doi: 10.1097/DCR.0000000000001051.
[24]
Rickard Matthew J F X (2005). Anal abscesses and fistulas. ANZ J. Surg.; 75: 64–72.
[25]
Davies M, Harris D, Lohana P, Chandra Sekaran TV, Morgan AR, Beynon J, Carr ND (2008). The surgical management of fistula-in-ano in a specialist colorectal unit. Int J Colorectal Dis. 2008 S; 23 (9):833-8. doi: 10.1007/s00384-008-0444-x.
[26]
Cadeddu F. Salis F Lisi G. Ciangola I. Milito G (2015). Complex anal fistula remains a challenge for colorectal surgeon. Int J Colorectal Dis.; 30 (5):595-603. Doi: https://doi.org/10.1007/s00384-014-2104-7.
[27]
de Parades V, Pommaret E, Fathallah N, Zeitoun JD, Bouchard D, Brochard C et al (2017). Fistules anales en 2017: les techniques d’épargne sphinctérienne ont-elles fait long feu? Hépato-Gastro & Oncologie Digestive; 24 (5), 427-430.
ADDRESS
Science Publishing Group
1 Rockefeller Plaza,
10th and 11th Floors,
New York, NY 10020
U.S.A.
Tel: (001)347-983-5186