Fistulotomy With or Without Marsupialization for Treatment of Simple Anal Fistula

Fistuolotomy With or Without Marsupialization for Treatment of Simple Anal Fistula: a Randomized Controlled Trial

Patients with simple anal fistula will undergo fistulotomy operation and will be divided into two groups: the first will undergo marsupialization of the laid open fistula track and second group will not undergo marsupialization. The effect of marsupialization on healing of anal fistula will be compared postoperatively.

Inclusion Criteria:

• Both genders
• Age: 18-65 years
• All Patients with primary simple anal fistula (subcutaneous, intersphincteric, or low trans-sphicnteric involving less than 25% of external anal sphincter fibers).

Exclusion Criteria:

• High trans-sphincteric, extra-sphincteric, supra-sphincteric, secondary.
• Recurrent anal fistulas.
• Patients associated with anorectal pathology such as anal fissure, hemorrhoids, rectal prolapse, neoplasm, solitary rectal ulcer, inflammatory bowel diseases and TB.
• High risk patients according to ASA (American society of anesthesiologists )
• Any degree of incontinence.
• Patients with previous anal surgery.