1999 Volume 52 Issue 6 Pages 524-528
Sphincter-preserving surgery for low intersphincteric anal fistulas is performed to maintain the shape and function. This technique has undergone various modifications in order to obtain a high cure rate in addition to the above advantages. In our basic procedure, the primary focus is dissected from the secondary opening so as to minimize the defect in the internal sphincter that is created by dissection of the fistulous tract from the primary opening.Then the primary opening is closed by suturing.
In patients with little damage to the internal sphincter, the fistulous tract does not recur easily even if the primary opening is not reconstructed. Therefore, 40 patients were treated by a method in which the fistulous tract within the internal sphincter was not dissected and the sphincter was left intact as a screen. With this method, favorable results have been obtained so far without suturing the primary opening. This method is also advantageous with regard to the maintenance of anal function.
