Evulation of anal sfincter functions, reccurens rates and quality of life after surgery of transsfincteric fistul in ano

İntroduction: Anal fistula is a disease that has been known since the early days of the history of medicine and the treatment. The balance between the two parameters development of recurrence and incontinence important to evaluate the success of treatment. In this study, we aim to asses the result of treatment and anorectal functions of the patients who underwent surgical for transsfincteric anal fistulmaterıal and Methods: A retrospective study was conducted on 52 patients that treated with anorectal fistula disease in the Department of General Surgery, Faculty of Medicine, Dokuz Eylul University between July 1993 - August 2010. Patients were divided into 2 groups: Loose seton alone (Group 1) and fistulotomy and / or loose seton (Group 2). Anal continence, Wexner incontinence questionnaire, anorectal manometry (anal canal resting pressure [RP], and anal canal squeeze pressure [SP]), and quality of life questionnaire ("fecal incontenence quality of life scale" [FIQL]) were used to evaluate the treatments results.Results: 13 (25%) women and 39 (75%) male of 52 patients were participated in this study. Surgical procedure were performed to 31 patients with High transsfinkterik and 21 patients with low transsfinkterik fistula (fistulotomy least and / or loose seton 40, seton only loosely to 12). Symptomatic incontinence was detected 25% of patients (n = 3) with only loose seton, 50% of patients (n = 20) with fistulotomy and / or loose seton.36 (69.1%) of patients had a complete remission and 16 (30.9%) of patients had no improvement or recurrence. When healed and unhealed and / or recurrence of the two groups were compared; Mean Wexner score of healed patients (P = 0.04) were significantly high. When we compared the patients who were treated by loose seton alone without fistulotomy and fistulotomy and / or loose seton: resting anal canal pressures, 72 mmHg ve 63 mmHg (P=0.05), squeeze pressure 139 mmHg ve 112 mmHg (P=0.02) respectively. FIQL scores of patients were treated by fistulotomy was significant (P = 0.04) and FIQL scores indicated that fistulotomy decreased the life quality of patients.Discussion and Conclusions: After surgery of Transsfincteric fistulas: patients who were treated by fistulotomy had a higher healing rate compared to loose seton alone patients: on the other hand fistulotomy increased the development of incontinence and decreasedthe life quality of patients were objectively revealed in all patients by using anorectal manometry and FIQL questionnaire .