Published online Apr 7, 2015. doi: 10.3748/wjg.v21.i13.4020
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: 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.