Retrospective Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Jun 27, 2025; 17(6): 106531
Published online Jun 27, 2025. doi: 10.4240/wjgs.v17.i6.106531
Modified fistulotomy with internal orifice distalization for optimized perianal fistula management: Pressure zone transition
İsmail Cem Eray, Burak Yavuz, Ishak Aydin, Serdar Gumus, Ugur Topal, Kubilay Dalci
İsmail Cem Eray, Burak Yavuz, Ishak Aydin, Serdar Gumus, Ugur Topal, Kubilay Dalci, Department of General Surgery, Çukurova University Faculty of Medicine, Adana 01130, Türkiye
Author contributions: Eray İC was responsible for study conceptualization, data acquisition, drafting of the manuscript, and providing final approval of the published version; Yavuz B was responsible for data analysis, manuscript revision, and providing final approval of the published version; Aydin I was responsible for study conceptualization and design, drafting of the manuscript, and providing final approval of the published version; Gumus S was responsible for study conceptualization, data acquisition, manuscript revision, and providing final approval of the published version; Topal U was responsible for study conceptualization, data analysis and interpretation, manuscript revision, and providing final approval of the published version; Dalci K was responsible for data analysis and interpretation, manuscript revision, and providing final approval of the published version.
Institutional review board statement: This study was conducted with the approval of the Çukurova University Faculty of Medicine Ethics Committee, under decision number 138, dated 03.11.2023. All procedures performed in studies involving human participants were carried out in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
Informed consent statement: Informed consent was obtained from all participants included in the study. Each participant was provided with comprehensive information regarding the nature of the study, the procedures involved, potential risks and benefits, and their rights as research subjects, including the right to withdraw from the study at any point without any consequences.
Conflict-of-interest statement: The authors report having no relevant conflicts of interest for this article.
Data sharing statement: The anonymized data used in their research are available from the Corresponding Author upon reasonable request.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ugur Topal, MD, PhD, Assistant Professor, Department of General Surgery, Çukurova University Faculty of Medicine, 01790, Sarıçam, Adana 01130, Turkey. sutopal2005@hotmail.com
Received: February 28, 2025
Revised: March 21, 2025
Accepted: May 8, 2025
Published online: June 27, 2025
Processing time: 91 Days and 15.2 Hours
Core Tip

Core Tip: This study introduces an innovative modification of the fistulotomy technique for perianal fistulas that focuses on distalizing the internal opening away from the high-pressure zone. By excising the fistula tract up to the external sphincter, widening the internal orifice, curetting the inter sphincteric septic focus, performing a partial internal sphincterotomy, and employing absorbable sutures with loose seton placement, this method achieved complete healing in 83.3% of the 72 patients treated with it, while maintaining low recurrence (4.2%) and minimal incontinence (12.5%) rates.