03-DİĞER

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Browsing 03-DİĞER by Subject "Abseler"

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    Perianal abse drenajından sonra verilecek antibiyotik tedavisi perianal fistül gelişimini etkiler mi?
    (Tıp Fakültesi, 2009) Sözener, Ulaş; Ersöz, Sadık; Genel Cerrahi
    It is known that approximately 35% of abscesses will lead to fistula formation after surgical drainage. The aim of our study is to determine if the addition of antibiotics to the treatment regimen changes this ratio.Patients who underwent abscess drainage in 3 major colorectal units between September 2005 and January 2008 were included. Previous anorectal surgery history, immune compromised states, pregnancy, inflammatory bowel disease, antibiotic usage prior to surgery and presence of anal fistula at the operation were exclusion criteria. Patients were randomized and given placebo or antibiotic treatment for 10 days after drainage. Patients were followed for perianal fistula formation at the end of 3rd month, 6th month and 1st year by a physician who was blind to antibiotic treatment.139 patients were included to the study (76.3% male). Mean age was 38. The majority of the anorectal abscesses were perianal (57%) which is followed by Intersphincteric and Ischiorectal respectively. Only 1 case of supralavator abscess was present. After proper surgical drainage, 64 patients (46%) were given antibiotic treatment while the rest received placebo.We found that 27% of the patients developed anal fistula in the follow up. We did not find any difference in terms of fistula formation between the placebo and antibiotic groups (p=0.08). The only statistical significant relationship was between the abscess type and the development of fistula. In that relationship, ischiorectal group had the most increased risk for development of fistula. Duration of symptoms, drainage method or placement of drain had no correlation with the development of fistula.We didn?t find any preventive effect of postoperative antibiotic treatments in terms of fistula formation. We may conclude that, as long as adequate surgical drainage is performed, there is no need for additional treatment for perianal abscess.Further studies should be conducted, especially focusing on Ischiorectal abscess patients, to better understand the mechanisms of fistula formation.