2015 Volume 68 Issue 2 Pages 75-80
Background: Sphincter-preserving fistulectomy is a basic surgical procedure for low intersphincteric fistula-in-ano. However, the failure rate is relatively high at 5-10%. Therefore, the Miyata-Ieda method (MI method), which covers the primary opening with a myomucosal advancement flap and the fistula tract is retained in the anal sphincter, is now performed. This retrospective study compares the outcomes of the conventional sphincter-preserving fistulectomy (Takano method) with the MI method.
Patients and methods: The MI method was performed on 101 patients between January 2011 and March 2013 and the Takano method was performed on 250 patients between May 2004 and December 2013 at Takano hospital and Ieda hospital. Outcome measures included recurrence, operation time and fecal incontinence.
Results: Operation times were 17 minutes (MI method) and 19 minutes (Takano method). Recurrence was significantly lower in the MI method (2.0% vs 7.6%). Patients who underwent the MI method experienced lower gas incontinence but there was no significant difference. Moreover, there was no significant difference in the pre- and post-operative mean anal pressure in the MI group.
Conclusion: The MI method is a safe and effective method for the treatment of low intersphincteric fistula with a low recurrence rate.
