Clinical Experience with Lift Technique For Complex Anal Fistulas

An anal fistula is an abnormal pathological tract between the anal canal and the perianal skin which primarily originates from the abscess formation with crypto-glanduler infection. The estimated prevalence of anal fistula is 12 to 28/100.000 of theper year and male to female ratio is 1.8:1.The classification of the anal fistula has shown variabilities, but the simplest and the most widely used one is the Park’s classification. In this classification five main types are described according to the relationship of the fistula to the anal sphincter muscles; intersphincteric, transsphincteric, suprasphincteric, extrasphincteric and superficial fistulas. 

This system doesn’t describe the presence of abscesses, fistulas connections to bladder or vagina, so that modified Park’s classification system had been formed. The anal fistulas are also described as simple or complex fistulas by American Gastroenterological Association. The simple fistulas originate below the dentate line (low type) and involves small part ofthe sphincter complex. Superficial, low intersphincteric or low transsphincteric fistulas are in this group.

Conversely complex fistulas originate above the dentate line (high type), and involves the significant part of the sphincter mechanism. Anterior fistula in women, recurrent fistula,fistulas with multiple tracts, patients with preexisting incontinence are included in this group. And complex fistulas may be associated with local irradiation or Crohn disease. Read more>>>>>>>>>>>>>>