A Novel Surgical Technique for Anal Fistula Surgery Designed to Preserve the Anal Sphincter Function and Anoderm

• Main Authors: Yasuhiro Shimojima, Makoto Matsushima, Sayuri Matsushima, Yotaro Watanabe, Ayumi Beniya, Yoshioki Hikosaka, Remi Katori, Naomi Matsumura, Yoichi Kono, Kosuke Okamoto, Masahiko Fukano, Joji Kuromizu
• Format: Article
• Language: English
• Published: The Japan Society of Coloproctology 2021-01-01
• Series: Journal of the Anus, Rectum and Colon
• Subjects: fpot; anal fistulas; fistulectomy; anal sphincter function
• Online Access: https://www.jstage.jst.go.jp/article/jarc/5/1/5_2020-032/_pdf/-char/en

Objectives: We reviewed surgical outcomes after introducing a novel surgical technique for anal fistula surgery designed to preserve anal sphincter function and the anoderm. Methods: We studied 200 male patients who underwent a functional preservative operative technique (FPOT group) for anal fistulas and 200 patients who underwent resection of trans-sphincteric anal fistulas (fistulectomy group) between February 2014 and September 2015. We compared complications, such as those affecting anal sphincter function, recurrence, and incontinence. Results: Fistulas recurred in three (1.5%) patients in the FPOT group and two (1%) patients in the fistulectomy group. This difference was not significant. Other complications included gas leakage and other forms of incontinence in 1 (0.5%) and 14 (7%) patients in the FPOT and fistulectomy groups, respectively. Anal function assessment demonstrated that the FPOT was significantly better at preserving function than fistulectomy in all patients. Conclusions: There were no significant differences between the FPOT and fistulectomy in terms of recurrence or complication rates. Also, because there was no decrease in postoperative anal function, we concluded that the FPOT is an effective preservative surgical technique for treating trans-sphincteric anal fistulas.