This study aims to compare the efficacy of two surgical techniques in treatment of complex anal fistulas. The first technique involves rerouting of the fistula tract with placement of a vessel loop seton around the internal anal sphincter, sparing the external sphincter whereas the second technique entails ligation of inter-sphincteric fistulous tract (LIFT). The main objectives of the study are to assess the success rate, time to healing, change in quality of life, and complications of each procedure including fecal incontinence.

Inclusion Criteria:

• Adult patients of either sex with complex anal fistula including high trans-sphincteric, supra-sphincteric, extra-sphincteric, and anterior fistula in female

Exclusion Criteria:

• Patients with simple anal fistulas, including intersphicnteric and low trans-sphincteric fistulas.
• ASA IV and V (The American Society of Anesthesiologists Physical Status classification system) unfit patients
• Patient with any grade of anal incontinence.
• Patients with concomitant anal pathology.