Outcomes of Various Interventions for First-Time Perianal Abscesses in Children

Abstract EN

Introduction.

In children treated surgically for first-time perianal abscesses, discovery and excision of concomitant fistulas may also be warranted.

Aim.

To evaluate children of varying age after incision and drainage of first-time perianal abscesses, examining recurrences rates with and without search for a fistula.

Method.

A retrospective review was conducted, analyzing children (ages 0–15 years) treated for first-time perianal abscesses at a tertiary pediatric surgical center, with a minimum follow-up of 6 months.

Results.

A total of 104 patients subjected to 112 treatments for first-time perianal abscesses were eligible.

Surgical procedures constituted 84 (75%) of treatments, searching for fistulas in 49 (58%).

In 34 (69%), fistulas were confirmed and treated.

In the surgically treated subset, the recurrence rate was higher if no attempt was made to exclude a fistula (46%), as opposed to confirmed absence of a fistula (27%) or concurrent fistulotomy (9%; p = 0.02 ).

Younger patients showed a higher recurrence rate (12/26; 46%), compared with older counterparts (11/58; 19%) ( p = 0.002 ).

Conclusion.

In children surgically treated for first-time perianal abscess, recurrence rates appear to be lowered by locating and treating coexisting fistulas.