[Results with a new therapy concept in anal fistula: suture of the anal sphincter].

Eleven patients with suprasphincteric, translevatoric, or high transsphincteric fistula and 10 patients with low (transsphincteric or intersphincteric) fistula were treated by fistulectomy using sphincterotomy or a transsphincteric approach, with primary sphincter reconstruction. After a follow-up of 2-9 months one patient had a recurrence and in a further patient the internal anal sphincteric suture had become dehiscent, necessitating sphincteroplasty. 20 patients (95%) had a perfect anatomic and clinical functional result without recurrence. Fistulectomy with primary closure proved to be a safe treatment modality for primary and recurrent high and low fistula, with the advantages of rapid wound healing and of avoidance of continence disturbance due to sphincter division, anal canal deformity, or mucosal flap ectropion.