Endorectal flap advancement repair versus seton fistulotomy for high anal fistuala

ABSTRACT

In this study, the clinical results of endorectal flap advancement were assessed and compared with the results of the traditional seton fistulotomy technique for treatment of high transsphincteric and suprasphincteric anal fistulas, trying to search for a definite role of endorectal flap advancement in the management of high transsphincteric and suprasphincteric anal fistulas. A total of twenty three patients with high transsphincteric [n= 19] and suprasphincteric [n=4] fistulas were randomized into endorectal advancement flap repair [11 patients] or two-stage seton fistulotomy [12 patients] in a prospective study during the period from September 1996 to May 2001 at Ain-Shams University Hospitals. Clinical outcome was assessed in terms of continence and recurrence during a follow-up for three months after operation. Successful healing was achieved in 10 patients of the group randomized to endorectal advancement flap repair and in 10 patients of the group randomized to two-stage seton fistulotomy. Recurrent fistula occurred in one patient of the endorectal advancement flap group and in 2 patients of the seton group. Continence disturbance in the form of lack of control of gas was noted in one patient of the first group and in 2 patients of the other group