Sphincter-preserving techniques for anal fistulas in Japan

Area of Science:

• Colorectal Surgery
• Surgical Innovation

Background:

• Following seminal works and classification systems, Japanese surgeons actively developed novel sphincter-preserving procedures.
• Focus has been on treating low intersphincteric and ischiorectal fistulas.

Purpose of the Study:

• To review and summarize sphincter-preserving surgical techniques for anal fistulas developed in Japan.
• To identify procedural transitions and analyze recurrence rates, cure rates, and variations.

Main Methods:

• Literature review of surgical procedures for anal fistulas.
• Summary and comparison of "coring-out" and "muscle-filling" techniques.
• Analysis of reported recurrence and cure rates for different fistula types.

Main Results:

• Japanese surgeons favor sphincter-preserving techniques, particularly "coring-out" methods for low intersphincteric fistulas.
• Common sphincter-preserving approaches for ischiorectal fistulas include "coring-out" and muscle-filling procedures.
• Recurrence rates are 5-6% for intersphincteric fistulas and 7-10% for ischiorectal fistulas.

Conclusions:

• Sphincter-preserving surgical techniques are effective for low intersphincteric and ischiorectal fistulas.
• Japanese surgical contributions have advanced sphincter-preserving options for anal fistula treatment.
• These techniques offer favorable outcomes with manageable recurrence rates.