الفهرس 
Introduction and aim of the workOnly 14 pages are availabe for public view
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Abstract
Anal fistula is a common problem that causes significant morbidity in 3rd , 4th and 5th decade of life of healthy population. In our study, all patients with perianal fistula duo to chronic non specific inflammation this information was based on pathological examination of the fistulous tract. No other secondry causes were detected. Accordingly, operations for fistula-in-ano had been designed to decrease the incidence of post operative incontinence and avoid recurrence. The aim of this study was to evaluate the clinical results after fistulectomy or fistulectomy with endorectal advancement flap repair for anal fistulas as regards healing, recurrence, and continence also, to study the effect on anal sphincter function using anorectal manometry. All patients of this study were subjected to the following: 1- Full history taking. 2- Thorough clinical examination. 3- Routine laboratory investigation. 4- Pre and post operative assessment of anal sphincter dysfunction using: ” Anal manometric study. ” Endo anal ultrasound. 5- Fistulogram. 6- Follow up of our patients have been fulfilled every 2 weeks for about 6 months with clinical assessment of patients as regards the clinical improvement , time of complete healing , the incidence of any degree of and incontivence according to Mansoura Nunero Alphabetic Scoring and recurrence rate. Our study showed that: ” Fistulectomy is simple, safe, effective for low anal fistulae because a minimal amount of anal sphincter is incorporated by the fistula. ” High anal fistula are among the most difficult problems faced in colorectal surgery . ” Fistulectomy is not advised for high anal fistulas because, it leads to an un acceptable risk of incontinence. ” Endo-rectal advancement flap is a safe, effective procedure for high anal fistula because, the anal sphincter is not divided. ” The risk of incontinence is more with fistulectomy than recto anal advancement flap, especially, fistulectomy of high anal fistula. ” In our study, there is no major post operative complication.