Non-operative Versus Operative Management of Perianal Abscess in Infants: A 10-year Retrospective Study at Two Centres in the United Kingdom
Topic overview
Retrospective UK study of 116 infants with perianal abscess found operative management (incision and drainage) reduced recurrence rates to 23% versus 53% with non-operative treatment. Non-operative patients required significantly more subsequent surgeries, though fistula-in-ano rates were similar between groups.
Key takeaways
- Perianal abscess in infants managed operatively had 53% lower recurrence rate compared to non-operative management (23% vs 53%, p=0.001).
- Non-operative management required significantly more subsequent surgeries (36% vs 16%, p=0.026) despite initial avoidance of anesthesia.
- Fistula-in-ano development rates were similar regardless of initial treatment approach (32% non-operative vs 19% operative, p=0.129).
- Operative management independently reduced recurrence risk by 75% (OR 0.25, 95% CI 0.09-0.68) in multivariate analysis.
- Median recurrence time was only 1 month, suggesting early operative intervention may prevent multiple procedures in infant perianal abscess.
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