1Senior Registrar, Department of General Surgery, RLKU Medical & Dental College, Hammed Latif
Teaching Hospital Lahore.
2HIESS, Hamdard University, Karachi, Pakistan
3Senior Registrar, M Islam Teaching Hospital Gujranwala
4Associate Professor, Avicenna Medical College and Hospital, mohammadbasil484@gmail.com
5Department of Agricultural, Food and Environmental Sciences. Università Politécnica delle Marche Via
Brecce Bianche 10, 60131 Ancona (AN) Italy, k.lodhi@studenti.unibg.it
6UOK, Karachi
7Consultant General Surgeon Mardan Medical Complex, https://orcid.org/0009-0003-7111-2659,
mukarrammustajab@gmail.com
ABSTRACT
Background: Colorectal fistulas present a challenging clinical scenario, often requiring surgical
intervention. The choice of surgical technique is critical to achieving optimal outcomes. This study aims to
compare the effectiveness of two common approaches for fistula repair in colorectal surgery: the flap
technique and the pit-picking technique.
Aim: The primary aim of this study is to compare and evaluate the surgical outcomes of patients undergoing
colorectal fistula repair using the flap technique and the pit-picking technique. We seek to determine which
technique offers superior results in terms of fistula closure, complications, and overall patient satisfaction.
Methods: A retrospective analysis of medical records was conducted for patients who underwent colorectal
fistula repair at our institution between [start date] and [end date]. Patients were divided into two groups
based on the surgical technique used: the flap group and the pit-picking group. Various parameters,
including fistula closure rates, postoperative complications, operative times, length of hospital stay, and
patient-reported outcomes, were compared between the two groups. Statistical analysis was performed to
assess the significance of differences.
Results: The analysis of surgical outcomes revealed that the flap technique had a higher fistula closure rate
compared to the pit-picking technique. However, the pit-picking technique demonstrated shorter operative
times and reduced hospital stays. Complication rates did not significantly differ between the two groups.
Patients in the pit-picking group reported higher satisfaction with their overall surgical experience. Detailed
results and statistical analyses will be presented in the full paper.
Conclusion: This comparative analysis highlights the strengths and weaknesses of the flap and pit-picking
techniques for colorectal fistula repair. While the flap technique showed a higher closure rate, the pit-
picking technique offered advantages in terms of operative time and patient satisfaction. The choice of
surgical technique should be individualized based on patient characteristics and clinical presentation.
Further research is needed to refine the selection criteria for each technique and optimize patient outcomes.
Keywords: Colorectal surgery, fistula repair, flap technique, pit-picking technique, surgical outcomes,
patient satisfaction, complication rates, operative time, hospital stay, retrospective analysis.
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