Comprehensive treatment of suprahigh complex anorectal fistula:a report of 311 cases

Objective To improve the therapeutic result of suprahigh complex anorectal fistula. Methods The synthetic methods of celiotomy for uppermiddle rectal fistula, fistulectomy for anal fistula of below the levator ani muscle, threaddrawing to main fistula and embolism of ZT glue to branches of the fistula for anal fistula of over the levator ani muscle were used. Results 311 cases with suprahigh complex anorectal fistula were treated,celiotomy for 3 cases,celiotomy plus threaddrawing and fistulectomy for 6 cases,celiotomy plus threaddrawing and embolism and fistulectomy for 4 cases, threaddrawing plus embolism for 49 cases, threaddrawing plus embolism and fistulectomy for 87 cases,fistulectomy for 162 cases,303 cases were followed up, 296 cases were cured, the curative rate was 977%.Recurrence developed in 7 cases with a rate of 23%. ConclusionThat the key it is most important for a successful operation to manage the internal opening and medial extremity of fistula correctly, remove the branches of the fistula and infective substances from the dead space sinus thoroughly, and ensure the unobstructed drainage and thorough cleaning of the wound.The synthetic methods have wide adaptability in the treatment of high complex anorectal fistula.