Preoperative transrectal three-dimensional ultrasound improves complex anal fistula diagnosis and surgical outcomes

Background To explore the clinical value of preoperative transrectal three-dimensional ultrasound in diagnosing the internal opening and classifying complex anal fistulas, and to evaluate its impact on surgical efficacy. Methods A total of 42 patients with complex anal fistulas were divided into an observation group and a control group. The control group underwent conventional transrectal ultrasound examination, while the observation group underwent three-dimensional transrectal ultrasound examination. Perioperative data were recorded and compared between the two groups. Results The observation group showed significantly higher diagnostic accuracy (p = 0.014) and a higher cure rate (66.67% vs. 42.86%) than the control group. Anal sphincter function improved postoperatively in both groups, with the observation group achieving superior outcomes at 6 months. The observation group also demonstrated lower Wexner incontinence scores (p = 0.015), shorter hospitalization and wound healing times, and higher SF-36 scores in bodily pain, general health, and health transition domains. However, postoperative complication rates and 6-month recurrence rates were similar between the two groups. Conclusion Preoperative transrectal three-dimensional ultrasound can accurately identify the internal opening and fistula tract of complex anal fistulas, which is beneficial for improving treatment efficacy.