Abstract

Conventional treatment of anal fistulas depends from anatomical relationships of the fistula with striated sphincter complex. Location of primary opening is crucial, blind fistula does not exist. Low fistulas can be treated in a single procedure without remarkable consequence on continence. Anterior fistulas in female, multiparas and multioperated patients with impaired continence must be treated with caution with at least two stages. High anal fistulas will always be treated in several stages: first stage is drainage with a loose seton during two or three months followed by fistulotomy or cutting seton.

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