Open fistulectomy with sphincter fixation for anal fistula

Purpose: This study aimed to report clinical data and recurrence rates in patients with anterolateral low fistulas who underwent open fistulectomy with sphincter fixation. Methods: The study group consisted of 133 consecutive patients with anterolateral, low intersphincteric, or low trans-sphincteric fistulas who had undergone open fistulectomy with sphincter fixation between January 2006 and December 2010. This procedure involves complete removal of the fistula tract by incision of anal sphincters, followed by fixation of the sphincter muscles. Results: Success was achieved in 127 (95.5%) patients with a median follow-up time of 12 months. Anal fistula recurred in 4 cases (3%). Non-healing fistula with persistent anal discharge developed in 2 patients. Maximal resting pressure, but not maximal squeeze pressure, was significantly decreased after surgery. Five patients (4%) developed temporary anal incontinence after surgery. Conclusions: Open fistulectomy with sphincter fixation was effective for the management of patients with anterolateral low fistula in this study. The high success rate suggests that this procedure is a reasonable option in this group of patients.