Is Marsupialization Effective in Fistula Surgery ?

Objective: The present study aims to demonstrate the surgical and patient-reported outcomes of marsupialization after fistulotomy in intersphincteric and low transsphincteric fistulas. Methods: A consecutive number of 100 patients who were diagnosed with an intersphincteric (IS) or a low transsphincteric (LTS) fistula and underwent fistulotomy with or without marsupialization were included in this study. The study cohort was divided into two groups: fistulotomy with and without marsupialization. Results: The study population consisted of 77 male patients with a mean age of 37.59 +/- 10.83 years. The number of patients with IS fistulas was 56 (56%). The marsupialization was performed in 36 patients, 26 of them with LTS fistula. The mean VAS score was significantly lower in the marsupialization group than the no-marsupialization group (p=0.035). Moreover, the duration of wound healing was demonstrated significantly shorter in the marsupialization group than non-marsupialization group (p=0.039). Conclusion: Marsupialization is an effective and feasible technique for fistulotomy wounds in patients with simple fistulas in terms of reducing postoperative pain and duration of wound healing.