WAFİ ATTAALLAH, ABDULLA TAGHİYEV
Turkish Journal of Colorectal Disease - 2023;33(1):18-24
Aim: Anal fistulas constitute a challenging entity for general surgeons. To date, there is no optimal treatment for anal fistulas. This study aims to determine the rate of complete clinical healing after applying a 30% silver nitrate solution to treat anal fistula. Method: Consecutive adult patients with symptomatic, either primary or recurrent, crypto glandular anal fistulas presenting between February 2019 and January 2020 in one center were prospectively included in the study. Fistula tracts were irrigated with a 30% silver nitrate solution in an outpatient clinic, and irrigation was repeated when necessary. The primary outcome was the rate of complete clinical healing after the treatment. Factors that may have affected healing were also analyzed. Results: Among 83 consecutive patients with anal fistulas admitted to one center between February 2019 and January 2020, 72 were included in the study. After 30% silver nitrate irrigation, 34 (47%) patients had complete clinical healing. Patients were followed up for a median of 9 (4-16) months after treatment. The patients (n=15) followed up at 12 months and beyond exhibited 73% (n=11) complete clinical healing, while those (n=57) followed-up before 12 months only had 40% (n=23) complete clinical healing (p=0.002). Kaplan-Meier analysis showed that the estimated rate of complete clinical healing was 88% throughout the 15-month follow-up period. Conclusion: This study showed that 30% silver nitrate treatment is effective and safe for anal fistulas
