Annals of Coloproctology

2 "Anal fistula;Surgical treatment"

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Surgical Treatment of Anal Fistula.: Lee, Jong Kyun; J Korean Soc Coloproctol. 2006;22(3):214-220.

Abstract PDF: 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.

Surgical Treatment of Anal Fistula.: Jun, Soo Han; J Korean Soc Coloproctol. 2002;18(2):141-146.

Abstract PDF: Most anal fistulas are either intersphincteric or low transsphincteric and are treated by fistulotomy with a few recurrence and minimal risk of incontinence. In high and complicated fistulas, fistulotomy should not be used because of a high chance of incontinence. High transsphincteric or suprasphincteric fistulas, anterior fistulas in female, patients with coexisting inflammatory bowel disease, elderly patients with poor sphincter function, multiple simultaneous fistulas, or patients with multiple prior sphincter injuries need alternative technique to minimize the incidence of incontinence. The alternative techniques include seton placement, advancement flap closure, muscle filling procedure, fibrin glue, etc. depending on the status of fistula and patients. The various sphincter sparing techniques used widely are reviewed.

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