Surgical Treatment of Anal Fistula

Lee, Jong Kyun

Abstract

Various methods of surgical treatments were introduced for the treatment of anal fistulas. A surgeon has to select carefully the method most ideal to each type of anal fistulas. The fistulotomy is an ideal technique for the treatment of intersphincteric or transsphincteric fistulas because less serious problems of incontinence and/or recurrence follow after it. For the treatment of suprasphincteric and extrasphincteric fistulas, fistulotomy is of no use because of high incidence of incontinence. In such cases, most surgeons like to use the seton technique, muscle filling method, muscle closure method, advancement flap, re-route procedure, or fibrin glue injection in order to decrease the incidence of incontinence. The techniques and indications of each surgical procedure are reviewed in detail.