Although the basic treatment of anal fistula has changed little over the centuries, the management of complicated fistula has long been a problem because of the necessity of preserving at least some of anal sphincter mechanism.
In 1976, Parks presented an elaborate classification of anal fistula which elegantly demonstrated the anatomy of the anal canal.
The authors made a clinical study by Parks classification 95 patients with anal fistula. who were treated at Kyungpook National University from May, 1981 to August, 1983.
The results were as follows:
The anatomic types of fistula were intersphincteric(64%), transsphincteric(28%), suprasphincteric(3%), extrasphincteric(1%), and unclassified(4%). There were 12% of horseshoe extension.
The etiologic factors were non-specific perianal abscess(92%), tuberculosis(5%), trauma (2%), and herb injection for hemorrhoids(1%).
Male outnumbered female by ratio of 7.6:1, and age incidence was most prevalent in twenties and thirties comprising about 2/3 of total cases.
Length of history did not make any difference and 12% had previous history of fistula. opration.
Internal opening could not be found in 17.9%.
The operative method were lay-open(85%), coreout(2%), seton(5%), core-out with advancement flap(2%) and curettage(6%).
In this series, there were 3 recurrence and 5 fistulas that were unhealed for a long time after operation.
Among 72 follow up cases, 3 had incontinence of flatus, and 15 had slight or occasional soiling.
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