Resultados al año de la técnica TROPIS en el tratamiento de la fístula anal compleja

Abstract

Introduction

It is a priority to find surgical techniques that guarantee acceptable healing rates without sequelae in the treatment of complex anal fistula. The concept of the deep intersphincteric space as the origin of perianal sepsis has provided a new perspective, allowing the emergence of techniques such as TROPIS (transanal opening of intersphincteric space), with few published series to date. The aim of this study is to evaluate the healing rate and complications 1 year after the TROPIS technique as a treatment for complex anal fistula without hospitalization.

Method

Prospective, observational study from January 2021 to 2023. Patients with complex anal fistulas who met the inclusion criteria were treated using the TROPIS technique. A 1-year follow up review was conducted, assessing healing rates, recurrence, continence, and complications.

Results

A total of 23 patients with cryptoglandular complex perianal fistula were included (87% male, mean age 54.7 ± 9.6 years); 78.3% were treated for recurrent fistulas with an average of 3.3 ± 3.2 previous interventions. At 1 month, 82.6% of the patients had complete healing. At 3, 6, and 12 months, complete healing occurred in 63.6%, 61.9%, and 55.6%, respectively. One patient developed an abscess at 1 month. Continence was altered in 8.7%.

Conclusions

The treatment of cryptoglandular complex anal fistula with this procedure was safe and showed acceptable healing rates.