Two Stages Re-routing Versus Fistulectomy with Primary Sphincteric Reconstruction in Treatment of High Transsphincteric Anal Fistula | ||
| The Egyptian Journal of Surgery | ||
| Volume 44, Issue 3, July 2025, Pages 848-853 PDF (612.56 K) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/ejsur.2024.341707.1301 | ||
| Authors | ||
| Mohamed W. Arafa* ; Abd-El-Aal Ali Saleem; Emad Goma | ||
| Department of General Surgery, Faculty of Medicine, Sohag University, Egypt | ||
| Abstract | ||
| Background: Fistula in ano remains a challenging condition in colorectal surgery due to its high recurrence rate and potential for fecal incontinence. Various surgical techniques, such as seton placement, fibrin glue application, rectal advancement flaps, collagen plug insertion, fistulotomy with sphincter repair and fistula tract rerouting, have been described for its treatment. Nonetheless, no single technique consistently superior to the others. Obliterating the fistula tract while maintaining complete continence is the main objective of any therapeutic strategy. Objective: The outcomes of rerouting and fistulectomy with primary sphincteric reconstruction will be analyzed and compared in order to ascertain which procedure is better for treating high trans-sphincteric fistulas in ano. Patients and Methods: A randomized clinical trial was conducted between January 2023 and May 2024, involving 30 patients with high trans-sphincteric fistulas. Patients were randomized to either the fistulectomy and primary sphincteric repair group or the rerouting group. Results: Both groups exhibited similar results, with no statistically significant difference observed between them regarding the recurrence rate, postoperative complications and continence. Conclusion: In patients with high trans-sphincteric fistula-in ano, rerouting and fistulectomy with primary sphincteric reconstruction operations yield similar results in terms of healing rate, recurrence, continence, and quality of life; no treatment is better than the other. | ||
| Keywords | ||
| Re-routing; transsphincteric anal fistula; sphincteric reconstruction | ||
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