Abstract
Low-lying trans-sphincteric anal fistulas respond well to simple fistulectomy or fistulotomy. However, management of high fistulas has long been a serious problem because of the necessity of preserving at least some of the sphincter mechanism. The clinical results of endorectal flap advancement and fistulectomy for complex anal fistulas were assessed. A total of 103 consecutive patients with high trans-sphincteric (n = 91) and suprasphincteric (n = 12) fistulas undergoing endorectal advancement flap repair together with core fistulectomy were included in a prospective study. Clinical outcome was assessed in terms of continence and recurrence by an independent observer for a period of 1 year after operation. Successful healing was achieved in 96 patients (93 per cent). Recurrent fistula occurred in six (7 per cent) of the 91 patients in the trans-sphincteric group and in one of the 12 patients in the suprasphincteric group. Continence disturbance was noted in eight patients (8 per cent). Previous repair and the level of the fistula did not adversely affect the results obtained. Core fistulectomy associated with endorectal advancement flap repair is a safe and effective technique for any high trans-sphincteric and suprasphincteric fistula, with good results in terms of recurrence and anal continence.
Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
