ArticleTechniques in coloproctology2025
Rerouting of the tract in the treatment of high anal fistula: a single-center experience.
Article in Techniques in coloproctology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundHigh anal fistulae require more complicated treatment than low anal fistulae. Because of their complexity, this study aimed to assess the rerouting role in high anal fistulae treatment, as well as to assess recurrence and incontinence, and determine whether rerouting of the tract is a good option for treating high anal fistulae.
methodsThis is a prospective interventional study that was conducted on 83 patients with high perianal fistula, ranging in age from 18 to 72 years old, of both genders. All cases were assigned to history taking, laboratory investigations, clinical examination (general examination and local examination), and magnetic resonance imaging (MRI) for objective delineation of the fistulous tract and its association to the anal sphincters.
resultsAfter a minimum follow-up period of 9 months, five cases (6.02%) experienced recurrence. Mild incontinence was reported in four patients (4.8%), while four patients (4.8%) developed infection. In addition, tract gangrene was observed in two patients (2.41%). In multivariate regression analysis, suprasphincteric fistulae and infection were independent predictors for recurrence.
conclusionsThe rerouting procedure is a feasible and safe surgical option for managing high transsphincteric perianal fistulae. It is associated with low postoperative complication rates, including short-term recurrence. It combines the advantages of fistulotomy and sphincter-preserving fistula surgery. However, further studies involving a large number of suprasphincteric fistula cases are needed to evaluate the efficacy of the rerouting technique in treating such fistulae.
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