Skip to main content
Top
Published in: International Journal of Colorectal Disease 12/2010

01-12-2010 | Original Article

Prognostic factors for recurrence following the initial drainage of an anorectal abscess

Authors: Takaaki Yano, Michio Asano, Yasuhide Matsuda, Kazuhiko Kawakami, Katsuhiko Nakai, Masahiko Nonaka

Published in: International Journal of Colorectal Disease | Issue 12/2010

Login to get access

Abstract

Purpose

It is well known that recurrent abscesses and anal fistulas may develop following incision and drainage. In this study, the prognostic factors for recurrence of anorectal abscess were retrospectively examined following initial drainage.

Methods

Between November 2003 and April 2008, 205 patients with a diagnosis of anorectal abscess underwent initial incision and drainage at our hospital. We included only patients experiencing anorectal abscess for the first time, which represent the majority of anorectal abscess patients seen in regular clinical practice.

Results

Of the total of 205 subjects, 74 experienced recurrence and 131 were cured (without recurrence). An investigation on the prognostic factors for recurrence revealed that the time from disease onset to incision was the only significant prognostic factor (p = 0.001). Sex, age, body mass index, method of anesthesia, abscess location, anatomic classification, use of a drain, and comorbid diabetes mellitus had no influence on recurrence. The cumulative cure rates were 68.7% for 1 year, 64.2% for 2 years, and 63.5% for 3 years.

Conclusion

For patients undergoing incision and drainage of anorectal abscesses, obesity did not affect recurrence. Prompt incision of anorectal abscesses was important to avoid recurrence.
Literature
1.
go back to reference Scoma JA, Salvati EP, Rubin RJ (1974) Incidence of fistulas subsequent to anal abscesses. Dis Colon Rectum 17:357–359CrossRefPubMed Scoma JA, Salvati EP, Rubin RJ (1974) Incidence of fistulas subsequent to anal abscesses. Dis Colon Rectum 17:357–359CrossRefPubMed
2.
go back to reference Chabrot CM, Prasad ML, Abcarian H (1983) Recurrent anorectal abscesses. Dis Colon Rectum 26:105–108CrossRef Chabrot CM, Prasad ML, Abcarian H (1983) Recurrent anorectal abscesses. Dis Colon Rectum 26:105–108CrossRef
3.
go back to reference Shoelson SE, Herrero L, Naaz A (2007) Obesity, inflammation, and insulin resistance. Gastroenterology 132:2169–2180CrossRefPubMed Shoelson SE, Herrero L, Naaz A (2007) Obesity, inflammation, and insulin resistance. Gastroenterology 132:2169–2180CrossRefPubMed
4.
go back to reference Vasilevsky C-A, Gordon PH (1984) The incidence of recurrent abscesses or fistula-in-ano following anorectal suppuration. Dis Colon Rectum 27:126–130CrossRefPubMed Vasilevsky C-A, Gordon PH (1984) The incidence of recurrent abscesses or fistula-in-ano following anorectal suppuration. Dis Colon Rectum 27:126–130CrossRefPubMed
5.
go back to reference Cox SW, Senagore AJ, Luchtefeld MA, Mazier WP (1997) Outcome after incision and drainage with fistulotomy for ischiorectal abscess. Am Surg 63:686–639PubMed Cox SW, Senagore AJ, Luchtefeld MA, Mazier WP (1997) Outcome after incision and drainage with fistulotomy for ischiorectal abscess. Am Surg 63:686–639PubMed
6.
go back to reference Hamalainen KP, Sainio AP (1998) Incidence of fistulas after drainage of acute anorectal abscesses. Dis Colon Rectum 41:1357–1361CrossRefPubMed Hamalainen KP, Sainio AP (1998) Incidence of fistulas after drainage of acute anorectal abscesses. Dis Colon Rectum 41:1357–1361CrossRefPubMed
7.
go back to reference Knoefel WT, Hosch SB, Hoyer B, Izbicki JR (2000) The initial approach to anorectal abscesses: fistulotomy is safe and reduces the chance of recurrence. Dig Surg 17:274–278CrossRefPubMed Knoefel WT, Hosch SB, Hoyer B, Izbicki JR (2000) The initial approach to anorectal abscesses: fistulotomy is safe and reduces the chance of recurrence. Dig Surg 17:274–278CrossRefPubMed
8.
go back to reference Oliver I, Lacueva FJ, Perez Vicente F et al (2003) Randomized clinical trial comparing simple drainage of anorectal abscess with and without fistula track treatment. Int J Colorectal Dis 18:107–110PubMed Oliver I, Lacueva FJ, Perez Vicente F et al (2003) Randomized clinical trial comparing simple drainage of anorectal abscess with and without fistula track treatment. Int J Colorectal Dis 18:107–110PubMed
9.
go back to reference Schouten WR, van Vroonhoven TJMV (1991) Treatment of anorectal abscess with or without primary fistulectomy. Results of a prospective randomized trial. Dis Colon Rectum 34:60–63CrossRefPubMed Schouten WR, van Vroonhoven TJMV (1991) Treatment of anorectal abscess with or without primary fistulectomy. Results of a prospective randomized trial. Dis Colon Rectum 34:60–63CrossRefPubMed
10.
go back to reference Ho YH, Tan M, Chui CH et al (1997) Randomized controlled trial of primary fistulotomy with drainage alone for perianal abscesses. Dis Colon Rectum 40:1435–1438CrossRefPubMed Ho YH, Tan M, Chui CH et al (1997) Randomized controlled trial of primary fistulotomy with drainage alone for perianal abscesses. Dis Colon Rectum 40:1435–1438CrossRefPubMed
11.
go back to reference Onaca N, Hirshberg A, Adar R (2001) Early reoperation for perirectal abscess: a preventable complication. Dis Colon Rectum 44:1469–1473CrossRefPubMed Onaca N, Hirshberg A, Adar R (2001) Early reoperation for perirectal abscess: a preventable complication. Dis Colon Rectum 44:1469–1473CrossRefPubMed
Metadata
Title
Prognostic factors for recurrence following the initial drainage of an anorectal abscess
Authors
Takaaki Yano
Michio Asano
Yasuhide Matsuda
Kazuhiko Kawakami
Katsuhiko Nakai
Masahiko Nonaka
Publication date
01-12-2010
Publisher
Springer-Verlag
Published in
International Journal of Colorectal Disease / Issue 12/2010
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI
https://doi.org/10.1007/s00384-010-1011-9

Other articles of this Issue 12/2010

International Journal of Colorectal Disease 12/2010 Go to the issue