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Updated: Aug 11, 2026

Vessel-sparing Excision and Primary Anastomosis
Published on: January 7, 2019
[Anal fissure of cryptoglandular origin. Therapeutic options]
Enrique Casal1, Alberto de San Ildefonso, Juan Sánchez
1Unidad de Coloproctología, Servicio de Cirugía, Hospital do Meixoeiro, Complejo Hospitalario Universitario de Vigo, 36200 Vigo, Pontevedra, Spain. jose.enrique.casal.nunez@sergas.es
Abstract:
Anal fistula is a frequent condition. The most commonly accepted origin is infectious. The most widely used classification is based on cryptoglandular theory and on the position of the fistulous tract in relation to the anal sphincter. Physical examination will help to identify the type of fistula and allow its treatment to be planned. The most widely used complementary tests are endoanal ultrasound and magnetic resonance imaging. We review the various therapeutic options and their results, especially fistulotomy, endorectal advancement flap, use of sedal, anodermal advancement flap, sphincterorrhaphy with sphincter repair, and fibrin glue.
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