I request my younger surgical colleagues to acknowledge the fact that high fistula in ano is a clinical rarity; most often than not they are a result of surgical aggression. If one finds a track going too far deep within, it is safer to core it out well enough while looking for its inner opening at the Dentate line only. A true high fistula in ano requires a diversion colostomy and is better left to be tackled by a team specialised in it, who will have to divide the ano-rectal ring and then repair it to ensure the necessary fistulectomy.. |