[Management of primary non-classifiable anal fistulas].
In the surgery of anal fistulae, very demanding problems warranting special consideration are caused by the non-classifiable fistulae in ano.


RESULTS
Of 823 patients who underwent surgery for anal fistulae between 1993 and 1996, 38 (4.5%) were, according to Parks' classification, non-classifiable; the anal canal was intact. There was no internal opening. All patients had already undergone operations, some of them multiple. In 53%, complete healing of the fistula was achieved by using a single excision. In 47% a recurrence developed. During a second revision we explored the intersphincteric space and were able to reclassify the fistulae in 50% of the cases. A continent fistulectomy led to complete healing in these patients.


CONCLUSIONS
Non-classifiable fistulae in ano, in which an internal opening of the fistula cannot be found, can primarily be treated by a single excision of the fistula. If recurrence does occur, the patient should undergo exploration of the intersphincteric space in the region, where the cryptoglandular infection is suspected.
Coloproktologische Klinik, St. Joseph-Hospital, Duisburg-Laar.
A
A
Köhler
S
S
Athanasiadis
E
E
Psarakis
A
A
Ommer
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000601:surgery; D011379:Prognosis; D012003:Rectal Fistula / Q000145:classification / Q000209:etiology / Q000601:surgery*; D012086:Reoperation; D016896:Treatment Outcome
Vorgehen bei primär nicht klassifizierbaren Analfisteln.