Fistulotomy with Primary Sphincteroplasty for Complex Anal Fistulas: Balancing Cure with Continence Preservation

Highlight

– Fistulotomy with primary sphincteroplasty achieves a 91.9% primary healing rate and 96.9% final success rate in complex anal fistulas.
– Recurrence occurred in 8.1% of cases, with a low persistent recurrence rate of 3.1% after retreatment.
– No major fecal incontinence was observed; minor incontinence affected less than 5% of patients.
– Risk factors for recurrence include female gender, diabetes, smoking, higher BMI, and longer operative time.

Study Background