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International Journal of Latest Research in Science and Technology

DOI:10.29111/ijlrst   ISRA Impact Factor:3.35

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ALIGNMENT OF ANAL SPHINCTERS IN HIGH FISTULA: A NOVEL SURGICALTECHNIQUE

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International Journal of Latest Research in Science and Technology Vol.5 Issue 2, pp 56-58,Year 2016

ALIGNMENT OF ANAL SPHINCTERS IN HIGH FISTULA: A NOVEL SURGICALTECHNIQUE

Rezvan Mirzaei,Bahar Mahjoubi,Atefeh Kashanizadeh, Zahra Omrani

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Received : 18 April 2016; Accepted : 25 April 2016 ; Published : 30 April 2016

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Abstract

Background: High fistula-in-ano is difficult to treat due to concerns of postsurgical incontinence. We had an innovation as a technique with no recurrence rate and minimal negative effect on continence score. Method: This is a prospective study of 49 patients operated for high anal fistula, from 2010 to 2012. After resection of extra-sphincteric part of fistula, tract of fistula in transsphincteric portion is divided and then the surgeon decided that whether excise fibrotic tissue or saving them to achieve better alignment and at last both cross-sections of the cutting muscles placed in opposite side of each other with little distance by suturing edges of sphincter to the base of wound or to the skin instead of sphincter repair. Evaluation of the continence score and fistula recurrence rate of the patients with interval time of before and 6, 10 weeks and one year after surgery were conducted. Results: The mean age of the patients was 42.85±14.9 years. The mean length of fistula tract was 7±2.7. Also mean of wexner score before surgery was 1, and 6& 10 weeks and one year after surgery was 0.6, 0.56 and 0.5, respectively. Eight of patients had puborectalis involvement (16.3%) and nine of them (18.4%) had horseshoe fistulas. Forty four of forty nine patients (93%) after 10 weeks had complete healing. Conclusion: Alignment of sphincter can be a problem solving technique in high transsphincteric fistula surgery.

Key Words   
High transsphincteric fistula, Sphincter alignment, incontinence, Recurrence of fistula
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References
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To cite this article

Rezvan Mirzaei,Bahar Mahjoubi,Atefeh Kashanizadeh, Zahra Omrani , " Alignment Of Anal Sphincters In High Fistula: A Novel Surgicaltechnique ", International Journal of Latest Research in Science and Technology . Vol. 5, Issue 2, pp 56-58 , 2016


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