Endorectal Mucosal Advancement Flap for Treatment of Complex Anal Fistula

Authors

  • Paisit Siriwittayakorn Department of Surgery, Faculty of Medicine, Chiang Mai University. Chiang Mai 50200, Thailand
  • Somcharoen Saeteng Department of Surgery, Faculty of Medicine, Chiang Mai University. Chiang Mai 50200, Thailand
  • Narain Chotirosniramit Department of Surgery, Faculty of Medicine, Chiang Mai University. Chiang Mai 50200, Thailand

Keywords:

complex anal fistula, treatment, mucosal advancement flap

Abstract

               Sixteen patients who had complex anal fistula were treated in both private and government hospitals in Chiang Mai from 1992 to 1996. They comprised 12 men and 4 women. The treatment consisted of enlarging the external opening for well drainage, curetting the tract, and separating the fistulous tract from its communication with the anal canal by using the endorectal mucosal advancement flap. Nine of 16 patients (56%) produced satisfactory results. Among the failures, the longest period of time before symptom recurrence was 8 months. The causes of failure seemed to relate to the presence of diffuse internal hemorrhoids, taut anal mucosa, and failure to remove septic tissue in the fistulous tract.

References

1. Reznick RK, Bailey HR. Closure of the internal opening for treatment of complex fistula-in-ano. Dis Colon Rectum 1988; 31(2) :116-8.

2. Parks AG, Stitz RW. The treatment of high fistula in ano. Dis Colon Rectum 1976;19:487-99.

3. Jun SH, Choi GS. Anocutaneous advancement flap closure of high anal fistulas. Br J Surg 1999; 86:490-2.

4. Pino AD, Nelson RL, Pearl RK, Abcarian H. Island flap anoplasty for treatment of transsphincteric fistula in ano. Dis colon Rectum 1996; 39(2):224-6.

5. Aguilar PS, Plasencia G, Hardly TG Jr, Hartmann RF, Stewart WRC. Mucosal advancement in the treatment of anal fistula. Dis Colon Rectum 1985; 28(7):496-8.

6. Oh C. Management of high recurrent anal fistula. Surgery 1983;93(2) : 330-2.

7. Lewis P, Bartolo DCC. Treatment of trans-sphincteric fistulae by full thickness anorectal advancement flaps.Br J Surg 1990;77:1187-9.

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Published

1999-12-30

How to Cite

1.
Siriwittayakorn P, Saeteng S, Chotirosniramit N. Endorectal Mucosal Advancement Flap for Treatment of Complex Anal Fistula. Thai J Surg [Internet]. 1999 Dec. 30 [cited 2024 Nov. 23];20(4):133-6. Available from: https://he02.tci-thaijo.org/index.php/ThaiJSurg/article/view/247906

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Section

Original Articles