Diseases of the Colon & Rectum

, Volume 39, Issue 2, pp 224–226 | Cite as

Island flap anoplasty for treatment of transsphincteric fistula-in-ano

  • Alberto Del Pino
  • Richard L. Nelson
  • Russell K. Pearl
  • Herand Abcarian
Technical Notes


BACKGROUND: Treatment of fistula-in-ano often replaces one problem, risk of persistent anal sepsis, with another, either incontinence after fistulotomy or mucosal ectropion after rectal flap advancement. A new technique for treatment of transsphincteric fistulas is described that could eliminate risk of both complications. TECHNIQUE: Island flap anoplasty, previously used in management of anal strictures or ectropion, is modified to treat transsphincteric fistulas. RESULTS: The operation has been performed in 11 patients, 3 of whom had Crohn's disease. Follow-up varied from one to ten months. Early recurrences have occurred in three patients, two with Crohn's disease and one without. Remaining patients have done well. CONCLUSION: This procedure is technically easy to perform and appears to cure transsphincteric fistulas while preserving anal sphincter. In the event of persistence of fistula, other operative options are not eliminated by this procedure. We feel that further experience and longer follow-up is needed to define precise indications for this procedure and to determine if continence is improved more so than with standard fistulotomy.

Key words

Transsphincteric fistula Island flap anoplasty Surgical technique 


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Copyright information

© American Society of Colon and Rectal Surgeons 1996

Authors and Affiliations

  • Alberto Del Pino
    • 1
  • Richard L. Nelson
    • 1
  • Russell K. Pearl
    • 1
  • Herand Abcarian
    • 1
  1. 1.Department of Colon & Rectal SurgeryCook County Hospital and The University of IllinoisChicago

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