Re-routing of the track for the treatment of high anal and anorectal fistulae

Abstract

A transposition technique for the management of high anal and anorectal fistulae is described. The method involves re-routing the extrasphincteric portion of the track into an intersphincteric position with immediate repair of the external sphincter. The newly positioned intersphincteric fistula is then dealt with at a later date when the external sphincter is soundly healed. In this way the number of operations needed to deal with such a fistula may be reduced, a colostomy is not necessary, healing is more rapid and continence is preserved. Details of the first five cases dealt with in this way and their successful outcome are reported.