[Complex anal fistulas. Current status of their treatment]

Out of 643 anal fistulae operated, 85 were considered complex. The author details the precautions that must be used in their cure in order to avoid a recurrence or an incompetence. Operated with these principles, a great majority of these fistulae cured completely, without important sequellae of the sphincter function. A small percentage of these fistulae are difficult to treat and liable to recurrence. These are the ano-rectal high supposedly blind fistulae or those that have an internal opening above the ano-rectal ring. The author prefers the treatment by modificating injections, of which he has a large experience. This procedure does not always guarantee cure but yields frequent long remissions.