[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.
Köhler
A
A
Coloproktologische Klinik, St. Joseph-Hospital, Duisburg-Laar.
Athanasiadis
S
S
Psarakis
E
E
Ommer
A
A
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.