title: Coring-out fistulectomy with a newly designed 'fistulectome' for complicated perianal fistulae: a retrospective clinical analysis.
abstract: OBJECTIVE
  Conventional surgery for complex anal fistula (AF) is associated with continence disturbance and recurrence. In the hope of reducing these we developed a new mechanical device, the 'fistulectome', to excise the entire fistula tract.
  
  
  METHODS
  Between March 2001 and April 2011, 136 patients underwent surgery for a complex AF using the fistulectome. All fistulae were cryptoglandular in origin. Five patients were lost to follow up and were excluded from the analysis.
  
  
  RESULTS
  Of the 131 fistulae, 76 were trans-sphincteric, 14 were suprasphincteric and 16 were extrasphincteric. Seven had a horseshoe extension and 18 were unclassified. Of the 131, 108 had recurred after conventional fistulotomy performed at another centre and 23 were primary. The mean duration of follow up was 34.6 months, the mean hospital stay was 5 days and the healing time was 14 days. Recurrence, flatus incontinence and soiling occurred in 17 (12.9%), four (3.5%) and two (1.52%) patients.
  
  
  CONCLUSIONS
  The results of this series suggest that coring-out of a fistula using a fistulectome may be a valid treatment for complicated anal fistula.
authors.affiliation: Cerrahpasa Medical Faculty, Department of General Surgery, Istanbul University, Istanbul, Turkey.
authors.forename: I
authors.initials: I
authors.lastname: Tasci
authors.forename: S
authors.initials: S
authors.lastname: Erturk
authors.forename: O
authors.initials: O
authors.lastname: Alver
mesh_terms: D013505:Digestive System Surgical Procedures / Q000009:adverse effects / Q000295:instrumentation*; D005242:Fecal Incontinence / Q000209:etiology; D005414:Flatulence / Q000209:etiology; D005500:Follow-Up Studies; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D012003:Rectal Fistula / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Coring-out fistulectomy; complicated perianal fistulae; fistulectome