A Comparative Study Between Fistulectomy And Fistulotomy With Marsupialization In Management Of Simple Anal Fistula

Abstract

nal fistula is a common disease that has long challenged surgeons’ skills Perianal fistula, if not treated properly will result in one of two terrible complications, recurrence or incontinence. Despite many preoperative investigations that can help to identify the correct anatomy of the fistula, one might face difficult or unexpected intraoperative findings that require wise decisions. Appropriate decisions in such circumstances have a significant impact on the outcome of surgery and the patient's quality of life (Abou-Zeid., 2011). The risk of postoperative incontinence was shown to be greater for females than for males. It is commonly believed that women are more prone than men to incontinence after surgical treatment for the fistula because of the smaller sphincter mechanism that may also be impaired by vaginal childbirth (Takayuki et al., 2007). The ideal surgical treatment for anal fistula should eradicate sepsis and promote healing of the tract, whilst preserving the sphincters and the mechanism of continence. For the simple and most distal fistulae, conventional surgical treatment such as lay-open of the fistula tract as a complete transection of the tissue between the fistula tract and anoderm is very effective with a success rate of up to 100%. Although reported incontinence rates following fistula