The Outcome of Jump Technique in Patients with anal Fistula at Shohada-e-Tajrish Medical Center during 2010-2012

Introduction & Our aim is to introduce a new technique named Jump to help further the surgeons in the management of anal fistulae and to reduce further the complications. Several methods underwent test of time in the literature. Fistulotomy, Fistulectomy, seton, LIFT, Advancement flap, fibrin glue and plug, are remarkable among them. There are considerable complications and failures especially in complex fistulas which indicates new research planning.
Fifty patients with anal fistula of cryptoglandular origin including 30 simple, 20 complexes were studied. 20 cases with pilonidal sinus, inflammatory bowel disease, trauma irradiation and history of incontinence were excluded. In this technique external opening and tract was dissected by cautery and followed to reach the rectal wall. At second step an incision was made at anal verge and subanodermal pocket was created and followed up to internal opening. This two tunnel interconnected to each other by puncturing the rectal wall. At third step the tract was delivered from existing site to subanodermal position and fixed there. Patients were followed up to three years. Anal discharge and incontinence were the main complications to be reported. The results were analyzed by SPSS software 16 and Fisher exact test.
47 male and 3 females were studied which included, 30 simple fistulae, 20 complex, 13 recurrent cases and two previously seton inserted cases. Good results were obtained from all cases except for two previously seton inserted cases. Obtaining a 84% complete response in complex fistulas and 60% in simple fistulas brings a new hope in the treatment of this disease. Seton inserted cases were failed due to severe fibrosis around the tract which makes it not pliable enough to be divertable.
Jump technique was proved to be a good technique that can be used as a primary approach to all types of fistulae except for seton inserted fistulas which have severe fibrosis of the tract.