The Impact of Surgical Interventions on Quality of Life in Patients with Cryptoglandular Anal Fistula Using Quality of Life-Anal Fistula Questionnaire: A Pilot Cross-Sectional Study

Document Type : Original Article

Authors

1 Department of General Surgery, Colorectal Surgery Unit, Mansoura University Hospitals, Mansoura University, Mansoura, Egypt

2 Department of Clinical Sciences, MBBS Program, Fakeeh College for Medical Sciences, Jeddah, Saudi Arabia

Abstract

Objective: This pilot cross-sectional study evaluates the impact of different surgical interventions on the quality of life
(QoL) and continence in patients with cryptoglandular anal fistula (AF), using the QoL-AF questionnaire and Wexner and
St Mark continence scores.
Patients and Methods: Sixteen patients, aged 18–65 years, with primary or recurrent cryptoglandular AF underwent
surgical interventions, including fistulotomy, seton placement, and ligation of the intersphincteric fistula tract (LIFT).
Preoperative and postoperative QoL and continence scores were collected at 1, 3, and 6 months postsurgery. Paired t tests
and analysis of variance were used to assess the impact of surgical technique, fistula type, and presentation on outcomes.
Results: Significant improvements in QoL were observed at all postoperative time points, with fistulotomy and seton
showing greater improvements (average QoL changes of 29.57 and 28.25, respectively) compared to LIFT (21.00). The
intervention type had a significant impact on QoL (P<0.001), while the type and presentation of the fistula had no
significant effect. Postoperative continence scores also showed significant improvements, but weak correlations were
found between continence and QoL scores.
Conclusion: Fistulotomy and seton are associated with better QoL outcomes than LIFT in the treatment of cryptoglandular
AF. While fistula type and presentation did not affect outcomes, individualized treatment plans that prioritize patient QoL
should guide clinical decision-making. Further studies with larger sample sizes are needed to confirm these findings.

Keywords

The Egyptian Journal of Surgery
Volume 44, Issue 2
April 2025
Pages 584-587

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