Comparative Study of the FiXcision Device and the Ligation of Intersphincteric Fistula Tract Procedure for the Management of Fistula in Ano

Abstract

Introduction: Fistula-in-ano is an anorectal disorder that requires complete eradication of the fistulous tract while preserving anal sphincter function. Procedures like ligation of intersphincteric fistula tract have gained acceptance; while newer approaches like FiXcision device have been introduced to improve healing and reduce morbidity. Aim: To compare the clinical outcomes of fistulectomy using FiXcision device versus ligation of intersphincteric fistula tract in patients with intersphincteric and transsphincteric fistula-in-ano.
Methods: Study included 100 patients with fistula-in-ano. Group A underwent fistulectomy using the FiXcision device (n=50) and Group B underwent the ligation of intersphincteric fistula tract procedure (n=50). Operative findings, postoperative pain scores, wound healing, complications, hospital stay, time to return to normal activity, continence status, and histopathological findings were analysed. Statistical significance was set at p<0.05.
Results: Mean operative time was shorter in Group A compared to Group B (28.4 SD5.1 versus 31.2 SD6.8 minutes; p=0.003). Intraoperative blood loss was higher in Group A (p<0.001). Postoperative pain, analgesic requirement, hospital stay, number of dressing changes, and time to return to work were lower in Group B (p<0.001). Wound healing occurred earlier with Group B. Early complications were frequent in the Group A. Minor transient incontinence occurred in a few patients of Group A.
Conclusion: Both procedures achieved healing with preservation of continence. Group B demonstrated better early postoperative outcomes, faster recovery, fewer complications, and earlier wound healing, making it a favourable sphincter-preserving option in present study.