[Anodermal advancement flap-plasty as alternative treatment method to endorectal closure techniques in therapy of high anal fistulas. A prospective study of 31 patients].

From January 1992 until April 1995, 31 patients with trans- and suprasphincteric anal fistulae (transsphincteric n = 21; suprasphincteric n = 4; transsphincteric in Crohn's disease n = 6) underwent a fistulectomy followed by closure of the internal opening by suture and anocutaneous flap. All patients had undergone previous operations, some several times. The recurrence rate of 13% appeared to be low after a short follow-up. Continence was only negligibly impaired, although the anal resting pressure and contraction pressure were significantly reduced. In five patients a shortened prewarning period was noticed. Also in Crohn's fistulae the results were equivalent when the surgical treatment was performed in a non-inflammatory period.