Conversion of suprasphincteric fistula track into intersphincteric: results of a single center prospective trial
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Abstract
Objective. This study evaluates the efficacy of method of complex suprasphincteric anal fistulae treatment by conversion of suprasphincteric into intersphincteric fistula track (CFT). Material and methods. 24 patients (15 males, 9 females) with suprasphincteric fistulae were included. In 20 cases patients underwent CFT with excision of peripheral part of fistula, suturing of fistula opening through the wound and drainage of inter-sphincteric space (IS) by latex seton; 4 patients underwent CFT with mobilization of peripheral part of fistula to the rectal wall and full transposition of fistula track into IS. Mean follow-up was 20.2 months (range, 6-36). Results. Complete healing of wound and formation of a new intersphincteric fistula was observed in 12 (50%) patients. Success rate was 50% (10/20) after CFT with drainage of IS by latex seton and 50% (2/4) after CFT with transposition of fistula track into IS. Newly formed intersphincteric fistula excised after wound healing. Recurrence developed in 1 patient. No patients reported any incontinence postoperatively. Conclusion. Conversion of a suprasphincteric fistula track into intersphincteric could be a method of choice for treatment of patients with complex anal fistulae in cases when other sphincter-sparing methods were noneffective or when only cutting seton may be used.
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