Objective:

To demonstrate that one of the effective treatments for the resolution of high transsphincteric complex anal fistulas is the ligature of intersphinteric tract technique, since it is one of the procedures that has demonstrated adequate results for the resolution of the fistula, as well as the preservation of the anal sphincter and the continence.

Material and method:

This is a prospective and observational study of patients surgically treated with the ligature of intersphinteric tract technique for complex anal fistula (high transsphinteric), of cryptoglandular origin during the period between January 2016 and August 2018 in the Coloproctology Unit at the Hospital General de México “Dr. Eduardo Liceaga” in Mexico City. The clinical characteristics, the surgical technique and its result were analyzed.

Results:

A total of 23 patients with high transsphinteric fistula were included, who underwent the ligature of intersphinteric tract technique. only in one, recurrence of the fistula occurred. In the postoperative follow-up, one month after surgery, three patients presented with a perianal abscess at the site of the incision (13.04%), which required drainage and subsequent management with antibiotic. No patient presented fecal incontinence after surgical procedure, the median Wexner score was 0.

Conclusion:

In our experience, the ligature of intersphinteric tract technique was a safe, reproducible surgery with low morbidity and no fecal incontinence, with a success rate of around 90%, and could be considered as the first line of treatment in high trans-sphincteric complex anal fistula.

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