Endorectal Mucosal Advancement Flap for Treatment of Complex Anal Fistula
Keywords:
complex anal fistula, treatment, mucosal advancement flapAbstract
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.
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