Core out fistulectomy, anal sphincter reconstruction and primary repair of internal opening in the treatment of complex anal fistula.

摘要: Objective: To determine the surgical technique “core out fistulectomy with anal sphincter reconstruction and primary closure of internal opening” in treatment trans-sphincteric fistula (high type or long tract) supra-sphincteric terms healing, morbidity, recurrence continence. Material Method: Between January 2004 December 2005, 33 patients were enrolled present study. There 30 males 3 females median age 42 (range 19-73) years. Most high (94%). The who had intersphincteric fistula, short tract fecal incontinence, impairment excluded. Results: operative time was 35 20-90) minutes. Median follow up 14 6-20) months. healing 4 weeks (range: 2 to 5 weeks) minimal disturbance over patient life. one postoperative perianal hematoma treated by nonoperative mean four cases recurrent fistulas (cured second operation) no continence noted during follow-up period. Conclusion: Core opening is an effective procedure be considered a satisfactory result while preserving both external sphincters. Keywords: Anal canal, Fecal Reconstructive procedures, Rectal Surgical flaps, Surgery