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Conversion of suprasphincteric fistula track into intersphincteric: results of a single center prospective trial


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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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