2. Extensive and Complete Fistulectomy for Complicated Anorectal Fistula, Especially Total and Subtotal Resection of the Anus as Radical Surgery for the Deep and Wide Spread

Abstract

Total and subtotal resection of. the anus as radical surgery for complicated anorectal fistula deep and wide spread all around the anus does not leave so serious complications as having been believed.Even if internal and external sphincter are excised completely around the anus, anal function is able to remain without so serious disturbance as long as the surgery is performed following the cardial principle of anorectal surgery being accompanied with proper post operative treatment and after care. But it is quite seldom to encounter such serious case, which needs total resection of the anus. I have only three cases of the total resection among 500 cases of fistula for last 5 years. These result may reveal that puborectal sling is most important factor to keep sphincter continence.I consider, it is quite difficult to expect its permanent and complete cure by partial fistulectomy resecting only primary opening and main tracts.