Table 1.

Item of the telephone interview: general health.

Identification number Initial Phone contact (home, mobile) Diagnosis Planned surgery:
Items
1.	Would you say that in general your health is excellent, very good, good, fair, bad or very bad? (in the last 30 days)	Please indicate
2.	Would you say that in general your bowel is?	Normal/ diarrhea/constip
3.	If constipated, please specify daily difficult evacuation Chronic constipation abdominal distention Worsening of the above symptoms	Yes/no Yes/no Yes/no
4.	Did you see blood at defecation? If yes how often?	Yes / no Rarely/daily
5.	Did your last laboratory exams report anemia?	Yes/no
6.	Would you say that in general your perceived pain, on the numerical scale 0 to 11, with 0 being “no pain” and 11 being “the worst pain imaginable” is__?	Please indicate
7.	Do you feel something out of the anus (Prolapse)? If yes is it is…?	Yes/no Intermittent/stable
8.	Do you have anal fistula?	Yes/no
9.	Do you have a seton in place?	Yes/no
10.	Do you have discharge from the fistula? If yes, its amount is …	Yes/No Little/large
11	Do you have abscess around the fistula? (Pain, swelling, fever) If yes does this occur…	Yes/no rarely/frequently
12.	Are you taking any medication? Please specify