Trial reportLangenbeck's archives of surgery2026
Prospective observation study of incision and drainage vs drainage and initial fistula management for perianal abscesses.
Trial report in Langenbeck's archives of surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
3 authors.
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Abstract
backgroundPerianal abscess is a common anorectal emergency, and simple incision and drainage (I&D) remains the standard initial treatment. However, failure to address an underlying fistulous tract at the primary surgery may result in high rates of abscess recurrence and subsequent fistula formation. The role of drainage with concurrent initial fistula management remains debated due to concerns regarding anal continence.
aimTo compare outcomes of simple incision and drainage versus drainage with initial fistula management in patients with acute perianal abscess, with special reference to abscess recurrence.
methodsThis Prospective observation studies was conducted in the Department of General Surgery at SRM Medical College Hospital and Research Centre from march 2025 to December 2025. A total of 142 patients with acute perianal abscess were randomized into two groups: Group A underwent simple I&D (n = 71) and Group B underwent I&D with primary fistula management (n = 71). Patients were followed for 10 months. Primary outcomes included abscess recurrence and fistula formation. Secondary outcomes included anal incontinence assessed using the Fecal Incontinence Severity Index (FISI), postoperative pain, wound healing time, and hospital stay. Statistical analysis was performed using SPSS v25.0 with p < 0.05 considered significant.
resultsAbscess recurrence was significantly higher in the simple drainage group (23.9%) compared to the drainage with fistula management group (4.2%) (p = 0.001). Fistula formation occurred exclusively in the simple drainage group (25.4%) (p < 0.001). Mean FISI scores were higher following simple drainage (5.10 ± 3.15) than drainage with fistula management (3.30 ± 2.13) (p < 0.001). Hospital stay was significantly shorter in the combined procedure group (p < 0.001), while postoperative pain scores were comparable.
conclusionDrainage with initial fistula management significantly reduces abscess recurrence and fistula formation without increasing postoperative pain, and is associated with better continence outcomes and shorter hospital stay compared to simple drainage alone.
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