Background and aim:High complex anal fistula is a clinical challenge for proctologists and a nightmare for patients.Although the sphincter-sparing approach seems an ideal surgical intervention,there remains room for i...Background and aim:High complex anal fistula is a clinical challenge for proctologists and a nightmare for patients.Although the sphincter-sparing approach seems an ideal surgical intervention,there remains room for improvement in treatment efficacy.Herein,we introduce an enhanced sphincter-sparing approach,namely the fistula occlusion with the internal sphincter flap(FOISF),for treating high complex anal fistulas.Methods:This study evaluated 15 patients with high complex anal fistulas who underwent FOISF between October 2021 and December 2022 in the Sixth Affiliated Hospital,Sun Yat-sen University(Guangzhou,P.R.China).Data on success rates,anal function,and various surgical characteristics were subjected to rigorous analysis.Results:All patients underwent the FOISF procedure,with a median operation time of 53 min.Fourteen patients achieved primary intention healing,while one patient healed by second intention.No recurrence was observed over a follow-up period of 14-30 months.All patients exhibited satisfactory anal continence,with no statistically significant difference observed between preoperative and postoperative Wexner scores(P=0.331).A significant improvement in the quality of life was observed when compared with the preoperative assessment(P<0.001).Conclusion:The preliminary results of the FOISF procedure present an effective approach to treat high complex anal fistula.展开更多
基金supported by the Sixth Affiliated Hospital of Sun Yat-Sen University Clinical Research-“1010”Program[grant number 1010PY(2022)-40]the Program of Guangdong Provincial Clinical Research Center for Digestive Diseases[grant number 2020B111117004].
文摘Background and aim:High complex anal fistula is a clinical challenge for proctologists and a nightmare for patients.Although the sphincter-sparing approach seems an ideal surgical intervention,there remains room for improvement in treatment efficacy.Herein,we introduce an enhanced sphincter-sparing approach,namely the fistula occlusion with the internal sphincter flap(FOISF),for treating high complex anal fistulas.Methods:This study evaluated 15 patients with high complex anal fistulas who underwent FOISF between October 2021 and December 2022 in the Sixth Affiliated Hospital,Sun Yat-sen University(Guangzhou,P.R.China).Data on success rates,anal function,and various surgical characteristics were subjected to rigorous analysis.Results:All patients underwent the FOISF procedure,with a median operation time of 53 min.Fourteen patients achieved primary intention healing,while one patient healed by second intention.No recurrence was observed over a follow-up period of 14-30 months.All patients exhibited satisfactory anal continence,with no statistically significant difference observed between preoperative and postoperative Wexner scores(P=0.331).A significant improvement in the quality of life was observed when compared with the preoperative assessment(P<0.001).Conclusion:The preliminary results of the FOISF procedure present an effective approach to treat high complex anal fistula.
