What are the surgical options for simple anal fistulas?

Updated: Nov 09, 2018
  • Author: Bruce M Lo, MD, MBA, CPE, RDMS, FACEP, FAAEM, FACHE; Chief Editor: Barry E Brenner, MD, PhD, FACEP  more...
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Answer

For simple anal fistulas, fistulotomy with or without marsupialization is recommended. [21] In the presence of an abscess with anal fistula, incision and drainage along with fistulotomy may be considered. This is associated with decreased recurrence (relative risk, 0.17; 95% confidence interval, 0.09-0.32; P< .001) but increased risk of continence disturbance. [47] Fibrin glue has also been studied, with the advantage of less risk of incontinence. However, success rates have been reported lower than those for fistulotomy (41.7%).


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