{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,20]],"date-time":"2026-06-20T11:31:17Z","timestamp":1781955077134,"version":"3.54.5"},"reference-count":31,"publisher":"Wiley","issue":"7Online","license":[{"start":{"date-parts":[[2009,7,9]],"date-time":"2009-07-09T00:00:00Z","timestamp":1247097600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2010,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p><jats:bold>Objective\u2002<\/jats:bold> Complex anal fistulas (CFs) are difficult to treat. Endoanal advancement flap (EAF) is one of the standard treatment options for such clinical conditions. Immediate sphincter repair after fistulectomy (ISR) is not commonly performed because of the fear of causing postoperative incontinence. The objective of this study was to compare the results of both techniques.<\/jats:p><jats:p><jats:bold>Method\u2002<\/jats:bold> We retrospectively analysed a prospectively entered database composed of 146 patients (112 M; 34 F), undergoing operations for CF of cryptoglandular origin. The patients were divided in two groups: Group A: (EAF); <jats:italic>n<\/jats:italic>\u2003=\u200371 patients; Group B: (ISR); <jats:italic>n<\/jats:italic>\u2003=\u200375 patients.<\/jats:p><jats:p><jats:bold>Results\u2002<\/jats:bold> Forty\u2010two fistulas (28.7%) were recurrent, 98 trans\u2010sphincteric (TS) and 37 suprasphincteric (SS). Twenty\u2010six (17.7%) patients had some degree of preoperative continence disturbances, 11 in Group A <jats:italic>vs<\/jats:italic> 15 in Group B (<jats:italic>P\u2003<\/jats:italic>=<jats:italic>\u2003<\/jats:italic>0.47).\u2002 After a mean follow up of 13\u2003months (12\u201360), fistula persisted or recurred in 13 (18.3%) patients in Group A <jats:italic>vs<\/jats:italic> eight (10.6%) in Group B (<jats:italic>P\u2003<\/jats:italic>=<jats:italic>\u2003<\/jats:italic>0.19) irrespective of the fistula type (TS or SS). Thirty\u2010one (43.6%) patients in Group A <jats:italic>vs<\/jats:italic> 16 (21.3%) in Group B presented postoperative continence disturbances (<jats:italic>P<\/jats:italic>\u2003&lt;\u20030.001). No changes were observed with the Faecal Incontinence Quality of Life Scale (FIQLS). Group A patients had a significant reduction of maximal rest pressure after surgery. After ISR, no significant changes in pressures were observed.<\/jats:p><jats:p><jats:bold>Conclusion\u2002<\/jats:bold> Immediate sphincter repair can be a therapeutic option in selected cases of CF, mainly when associated with incontinence or increased risk factors.<\/jats:p>","DOI":"10.1111\/j.1463-1318.2009.02002.x","type":"journal-article","created":{"date-parts":[[2009,7,10]],"date-time":"2009-07-10T01:55:48Z","timestamp":1247190948000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":33,"title":["Fistulectomy and sphincteric reconstruction for complex cryptoglandular fistulas"],"prefix":"10.1111","volume":"12","author":[{"given":"J. V.","family":"Roig","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Garc\u00eda\u2010Armengol","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. 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