OBJECTIVETo investigate the more reliable and effective operations for high anal fistula.

METHODSFrom Jan. 2002 to Oct. 2004, 117 cases suffering from high anal fistula were divided into two groups, and received tying therapy on main fistula with external anal fistulae excision (62 cases) or tying therapy on main fistula with external anal fistulae laid aside (55 cases). The curing time and recurrence were compared between the two groups.

RESULTSThere were no significant differences in basic clinical data between the two groups. There were 37 cases of high simple fistula, and 25 cases of complicated fistulae in resection group, while 39 cases of simple fistula and 16 cases of complicated fistulae in laying aside group. The curing time was 15-20 (17+/-2) days and no recurrence occurred after follow-up for half a year in resection group. The curing time was 25-55 (35+/-8) days and recurrence occurred in 6 cases (10.9%) in laying aside group including one case of high simple anal fistula and five cases of high complicated anal fistulae. There was statistical significance in treatment efficacy for high complicated anal fistulae (chi2=6.23, P=0.013), and the overall efficacy (chi2=5.06, P=0.024) between the two groups.

CONCLUSIONTying therapy on main fistula with external anal fistulae excision is a more effective treatment for high complicated anal fistulae.