Current management of cryptoglandular fistula-in-ano

Abstract

Fistula-in-ano is a difficult problem that physicians have struggled with for centuries. Appropriate treatment is based on 3 central tenets: (1) control of sepsis; (2) closure of the fistula; and (3) maintenance of continence. Treatment options continue to evolve - as a result, it is important to review old and new options on a regular basis to ensure that our patients are provided with up to date information and options. This paper will briefly cover some of the traditional approaches that have been used as well as some newer promising procedures.

Keywords: Anorectal; Cryptoglandular; Fistula; Ligation of the intersphincteric fistula tract procedure; Sphincter sparing.

Figures

Figure 1

The fistula is identified as it crosses the plane between the internal and external sphincters. Reprinted with permission from the American Society of Colon and Rectal Surgeons.

Figure 2

The fistula is dissected free, ligated and divided. Reprinted with permission from the American Society of Colon and Rectal Surgeons.