Idiopathic Fistula-in-ano

Overview

Journal World J Gastroenterol

Publisher Baishideng Publishing Group

Specialty Gastroenterology

Date 2011 Aug 31

PMID 21876614

Citations 16

Authors

Sherief Shawki

Steven D Wexner

Affiliations

Soon will be listed here.

Abstract

Fistula-in-ano is the most common form of perineal sepsis. Typically, a fistula includes an internal opening, a track, and an external opening. The external opening might acutely appear following infection and/or an abscess, or more insiduously in a chronic manner. Management includes control of infection, assessment of the fistulous track in relation to the anal sphincter muscle, and finally, definitive treatment of the fistula. Fistulotomy was the most commonly used mode of management, but concerns about post-fistulotomy incontinence prompted the use of sphincter preserving techniques such as advancement flaps, fibrin glue, collagen fistula plug, ligation of the intersphincteric fistula track, and stem cells. Many descriptive and comparative studies have evaluated these different techniques with variable outcomes. The lack of consistent results, level I evidence, or long-term follow-up, as well as the heterogeneity of fistula pathology has prevented a definitive treatment algorithm. This article will review the most commonly available modalities and techniques for managing idiopathic fistula-in-ano.

Citing Articles

Management of Complex Perianal Fistulas Using Platelet-Rich Plasma and Adipose-Derived Mesenchymal Stem Cells: A Case Series.

Goulas P, Karakwta M, Menni A, Zatagias A, Zevgaridis A, Pentara N Cureus. 2025; 17(1):e77495.

PMID: 39958108 PMC: 11828477. DOI: 10.7759/cureus.77495.

Development of a new patient-reported outcome measure for complex cryptoglandular fistulas (20-Item complex cryptoglandular fistula questionnaire): a qualitative study.

McCurdy J, Crooks P, Gwaltney C, Krupnick R, Cadogan K, Karki C J Patient Rep Outcomes. 2024; 8(1):99.

PMID: 39172310 PMC: 11341802. DOI: 10.1186/s41687-024-00729-5.

Evaluation of the Cutting Seton Technique in Treating High Anal Fistula.

Almughamsi A, Zaky M, Alshanqiti A, Alsaedi I, Hamed H, Alharbi T Cureus. 2023; 15(10):e47967.

PMID: 38034232 PMC: 10685990. DOI: 10.7759/cureus.47967.

A comparative study between high ligation of the inter-sphincteric fistula tract via lateral Approach Versus Fistulotomy and primary sphincteroplasty in High Trans-Sphincteric Fistula-in-Ano: a randomized clinical trial.

Awad P, Hassan B, Awad K, Elkomos B, Nada M BMC Surg. 2023; 23(1):224.

PMID: 37559044 PMC: 10413541. DOI: 10.1186/s12893-023-02117-0.

Would Surgeons Like to Be Submitted to Anal Fistulotomy? An International Web-Based Survey.

Ratto C, Marra A, Parello A, De Simone V, Campenni P, Litta F J Clin Med. 2023; 12(3).

PMID: 36769474 PMC: 9918049. DOI: 10.3390/jcm12030825.

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