{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T02:32:13Z","timestamp":1789698733722,"version":"4.0.1"},"reference-count":28,"publisher":"Hamad bin Khalifa University Press (HBKU Press)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025]]},"abstract":"<jats:p>\n                    <jats:bold>Background:<\/jats:bold>\n                    Anorectal abscesses are common surgical conditions associated with a high risk of recurrence or fistula formation. Although several studies have investigated the potential predictors, data from Saudi Arabia remain limited. This study aimed to assess the rate, timing, and predictors of recurrence or fistula formation following the primary surgical drainage of anorectal abscesses.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Methods:<\/jats:bold>\n                    We conducted a five-year retrospective cohort study at King Fahad Hospital of the University in Al Khobar, Saudi Arabia, including all patients who underwent surgical incision and drainage for a first-time anorectal abscess between January 2019 and December 2023. Demographic data, abscess characteristics, operative details, and follow-up outcomes were analyzed. Logistic regression and Cox proportional hazards models were used to identify the predictive factors.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Results:<\/jats:bold>\n                    Among 302 patients, 51.7% (\n                    <jats:italic>n<\/jats:italic>\n                    = 156) developed either a recurrent abscess (12.9%,\n                    <jats:italic>n<\/jats:italic>\n                    = 39) or an index perianal fistula (38.7%,\n                    <jats:italic>n<\/jats:italic>\n                    = 117) during follow-up. The mean time to recurrence was 19.5 weeks. Complex abscesses, observed in 28.1% (\n                    <jats:italic>n<\/jats:italic>\n                    = 85) of cases, were the only independent predictor of earlier recurrence (hazard ratios [HR]: 2.391,\n                    <jats:italic>p<\/jats:italic>\n                    &lt; 0.001). Preoperative imaging was also associated with an increased risk in logistic regression analysis. Seton placement was rare (2.6%,\n                    <jats:italic>n<\/jats:italic>\n                    = 8), despite intraoperative fistula detection in 17.9% (\n                    <jats:italic>n<\/jats:italic>\n                    = 54) of cases.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Conclusion:<\/jats:bold>\n                    Recurrence and fistula formation following drainage of first-time anorectal abscesses are common and tend to occur early. Abscess complexity is a key predictor of poor outcomes, highlighting the need for structured early follow-up and risk-based surgical planning.\n                  <\/jats:p>","DOI":"10.5339\/qmj.2025.101","type":"journal-article","created":{"date-parts":[[2025,12,2]],"date-time":"2025-12-02T06:30:22Z","timestamp":1764657022000},"source":"Crossref","is-referenced-by-count":2,"title":["Recurrence rate and postoperative fistula formation: A retrospective analysis of surgically managed cases of anorectal abscess"],"prefix":"10.5339","volume":"2025","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4233-583X","authenticated-orcid":true,"given":"Saleh A.","family":"Busbait","sequence":"first","affiliation":[{"name":"Department of Surgery, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia*Correspondance: Saleh A. Busbait sbusbait@iau.edu.sa"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3277","reference":[{"issue":"(1):","key":"B1","series-title":"J Med Assoc Thai","first-page":"61\u20135","article-title":"Incidence and factors influencing the development of fistula-in-ano after incision and drainage of perianal abscesses","volume":"93","author":"Lohsiriwat\n \nV","year":"2010"},{"issue":"(1):","key":"B2","series-title":"Arch Acad Emerg Med","first-page":"e69","article-title":"Risk factors of recurrent anal abscess in patients with type 2 diabetes mellitus; a 4-year retrospective study","volume":"10","author":"Alamdari\n \nNM","year":"2022"},{"issue":"(10):","key":"B3","series-title":"Tech Coloproctol","first-page":"897\u2013907","article-title":"Clinical characterization of patients with anal fistula during follow-up of anorectal abscess: A large population-based study","volume":"27","author":"Sanchez-Haro\n \nE","year":"2023"},{"issue":"(3):","key":"B4","series-title":"Dis Colon Rectum","first-page":"327\u201332","article-title":"Persistent fistula after anorectal abscess drainage: Local experience of 11 years","volume":"62","author":"Sahnan\n \nK","year":"2019"},{"issue":"(1):","key":"B5","series-title":"Cir Esp (Engl Ed)","first-page":"25\u201332","article-title":"Recurrence and incidence of fistula after urgent drainage of an anal abscess: Long-term results","volume":"100","author":"D\u00edaz\n \nCC","year":"2022"},{"issue":"(1):","key":"B6","series-title":"Dubai Med J","first-page":"43\u20136","article-title":"Incidence and risk factors affecting development of perianal fistulas after drainage of perianal abscesses","volume":"4","author":"Khalil\n \nOM","year":"2021"},{"issue":"(1):","key":"B7","series-title":"Ann Coloproctol","first-page":"27\u201331","article-title":"Incidence of anal fistula after pyogenic perianal abscess drainage in Kingdom of Bahrain","volume":"39","author":"Hasan\n \nZAIY","year":"2023"},{"issue":"(2):","key":"B8","series-title":"Dis Colon Rectum","first-page":"217\u201321","article-title":"Who is at risk for developing chronic anal fistula or recurrent anal sepsis after initial perianal abscess?","volume":"52","author":"Hamadani\n \nA","year":"2009"},{"issue":"(12):","key":"B9","series-title":"Int J Colorectal Dis","first-page":"1495\u20138","article-title":"Prognostic factors for recurrence following the initial drainage of an anorectal abscess","volume":"25","author":"Yano\n \nT","year":"2010"},{"issue":"(1):","key":"B10","series-title":"Int J Colorectal Dis","first-page":"4","article-title":"Fistula development after anal abscess drainage\u2014a multicentre retrospective cohort study","volume":"39","author":"Skovgaards\n \nDM","year":"2023"},{"key":"B11","series-title":"Tob Induc Dis","first-page":"31","article-title":"Prevalence and predictors of active and passive smoking in Saudi Arabia: A survey among attendees of primary healthcare centers in Riyadh","volume":"23","author":"Nasser\n \nS","year":"2025"},{"issue":"(1)","key":"B12","series-title":"Biosci Biotech Res Asia","first-page":"153\u20139","article-title":"The prevalence, risk factors and outcome of surgical treatment of acute perianal abscess from a single Saudi hospital","volume":"14","author":"Elhassan\n \nYH","year":"2017"},{"issue":"(1):","key":"B13","series-title":"BMC Gastroenterol","first-page":"334","article-title":"Study on the factors influencing the prognosis after perianal abscess surgery","volume":"23","author":"Dong\n \nS","year":"2023"},{"key":"B14","series-title":"Med Sci Monit","first-page":"7942\u201350","article-title":"Relationship between body mass index and recurrence\/anal fistula formation following initial operation for anorectal abscess","volume":"25","author":"Lu\n \nD","year":"2019"},{"issue":"(1):","key":"B1","series-title":"J Med Assoc Thai","first-page":"61\u20135","article-title":"Incidence and factors influencing the development of fistula-in-ano after incision and drainage of perianal abscesses","volume":"93","author":"Lohsiriwat\n \nV","year":"2010"},{"issue":"(1):","key":"B2","series-title":"Arch Acad Emerg Med","first-page":"e69","article-title":"Risk factors of recurrent anal abscess in patients with type 2 diabetes mellitus; 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