Transanal advancement flap repair of transsphincteric fistulas.

摘要: OBJECTIVE: The purpose of this study was to evaluate the healing rate transsphincteric perianal fistulas after transanal advancement flap repair and examine impact procedure on fecal continence. METHODS: Between January 1992 1997, 44 consecutive patients with a fistula passing through middle or upper third external anal sphincter underwent repair. There were 34 male patients, median age (range, 19–72) years. Twenty-four (55 percent) had previously undergone one more prior attempts at With patient in prone jackknife position, internal opening exposed using Parks retractor. crypt-bearing tissue around overlying anoderm excised. A layer mucosa, submucosa, fibers mobilized 4 6 cm proximally. base approximately twice width its apex. advanced sutured below level opening. follow-up 12 months. Fecal continence evaluated 43 by means questionnaire. RESULTS: Transanal successful 33 (75 percent). Success inversely correlated number attempts. In no only previous attempt 87 percent. two repairs dropped 50 15 (35 deteriorated Twenty-six (59 completely normal preoperatively. Ten these (38 encountered soiling incontinence for gas procedure, whereas three subjects (12 complained accidental bowel movements. Eighteen (41 disturbances time admission our hospital. (11 percent), deteriorated. CONCLUSIONS: results are good. who have outcome is less favorable. Remarkably, did not adversely affect status.