A modified sphincter-preserved procedure for high complex anal fistulas: a preliminary study.

The management of high complex anal fistulas has posed a significant challenge for surgeons. In this study, we presented a novel surgical procedure for managing high complex anal fistulas that combines core-out fistulectomy with suture repair of the external anal sphincter defect and endorectal advancement flap. A cohort of patients with high complex anal fistulas undergoing core-out fistulectomy combined with suture repair of the external anal sphincter defect and endorectal advancement flap between December 2020 and December 2021 was reviewed retrospectively. The median age of the patients was 43 (range: 25-53) years. All patients had high transsphincteric fistulas. Two of the five cases involved recurrent anal fistulas. During the median follow-up period of 23 (range: 23-34) months, no recurrence events were observed in the cohort. Furthermore, it was noted that no patients developed anal incontinence after the operation. Core-out fistulectomy combined with suture repair of the external anal sphincter defect and endorectal advancement flap is an effective procedure for the treatment of high complex anal fistulas.