Prospective Study
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Apr 7, 2015; 21(13): 4020-4029
Published online Apr 7, 2015. doi: 10.3748/wjg.v21.i13.4020
PERFACT procedure: A new concept to treat highly complex anal fistula
Pankaj Garg, Mahak Garg
Pankaj Garg, Mahak Garg, Indus Super Specialty Hospital, Haryana 134113, India
Author contributions: Garg P and Garg M thought of the concept, designed the study, acquired the data, analyzed it, drafted, revised and finally approved the draft; Garg P submitted the manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Correspondence to: Pankaj Garg, MBBS, MS, Indus Super Specialty Hospital, MS. 1042, Sector-15, Panchkula, Haryana 134113, India.
Telephone: +91-950-1011000 Fax: +91-172-2594556
Received: September 13, 2014
Peer-review started: September 13, 2014
First decision: October 14, 2014
Revised: October 22, 2014
Accepted: November 7, 2014
Article in press: November 11, 2014
Published online: April 7, 2015
Core Tip

Core tip: The PERFACT procedure is a simple, economical and novel method to cure complex fistula-in-ano. It is associated with little pain, low morbidity and minimal risk of incontinence as both the anal sphincters are completely preserved. It is quite effective in complex fistula cases where other methods do not have a high success rate, like in horseshoe fistula, fistula with multiple tracts, recurrent fistula and fistula with supralevator extension. The PERFACT procedure is also quite successful in cases where the internal opening cannot be localized and in patients presenting with perianal/ischiorectal abscess where it can be done as a definitive procedure at the initial presentation.