Skin Sparing Fistulectomy with Primary Sphincters Repair by Special Sutures for Management of High Perianal Fistula

Background: Fistula in ano is a common disease seen in the surgical outpatient department. Many procedures are advocated for the treatment of fistula in ano. However, none of the procedures is considered the gold standard. Aim of this study was to evaluate our procedure in the managing high perianal fistula.Methods: Between February 2014 and September 2015, 71 patients with high perianal fistula were managed by skin sparing fistulectomy and special sutures for primary repair of anal sphincters. The clinical outcome was assessed in terms of time for healing, continence and recurrence for followup period (ranged from 4 to 24 months).Results: Anorectal wounds were healed within 3 to 4 weeks. Complications included urine retention 9 patients (12.7 %), superficial wound infection 29 patients (40.9 %), and transient incontinence 33 patients (46.5 %) for flatus for period ranged from 2 to 3 weeks. No deep infection, no permanent incontinence were recorded. Recurrence was in one patient (1.4 %).Conclusion: Our technique is less invasive, rapid healing, maintain on normal configuration of anus, and associated with good results for high perianal fistula management.