DOI: https://doi.org/10.36347/sasjm.2025.v11i11.008

Pages: 1118-1119

Introduction: Anal fistula is a common condition of the anal canal, often resulting from cryptoglandular infection of the Hermann and Desfosses glands. Although benign, it significantly affects quality of life and poses therapeutic challenges due to recurrence and continence disorders. Objective: To describe the management of anal fistulas in the General Surgery Department of the Avicenne Military Hospital of Marrakech, highlighting epidemiological, clinical, and therapeutic aspects as well as surgical outcomes. Methods: A retrospective descriptive study was conducted on 109 patients operated on for anal fistula between January 2021 and December 2024. Data were collected from hospitalization records and operative reports. Results: A clear male predominance was observed (86% men, 14% women; sex ratio = 6.7). The mean age was 45.5 years (range 15–69), with the most affected group being 36–45 years (25.9%). Previous anal surgery was common, including fistulectomy in 23% and abscess drainage in 12.8%. The main symptoms were perianal discharge (86.2%) and anal pain (66%). Surgical management was dominated by fistulectomy with slow sphincterotomy using an elastic seton (69%), followed by abscess drainage (14%). Early postoperative complications included acute urinary retention (20%) and transient gas incontinence (21%). Long-term outcomes showed 20% recurrence and 15% delayed healing. Conclusion: Surgical treatment remains the cornerstone of anal fistula management. The gradual sphincterotomy technique using an elastic seton provides effective healing while preserving continence and minimizing recurrence. Careful exploration and close postoperative follow-up are essential for optimal outcomes.