The goal of this clinical trial is to study whether the minimally invasive approach in the mucosal advancement flap technique for the treatment of complex perianal fistula improves the healing rate compared to non-minimally invasive surgery. The main question it aims to answer is: \- Does the healing rate of patients undergoing minimally invasive approach in the mucosal advancement flap technique improve compared to patients undergoing non-minimally invasive surgery? Researchers will also compare minimally invasive approach in the mucosal advancement flap technique to the non-minimally invasive approach in terms of postoperative pain, fecal incontinence and healing time. Quality of life and global morbidity will also be analyzed. Participants will: * Undergo surgical treatment of complex perianal fistula performed by mucosal advancement flap performed by a minimally invasive technique. * Attend control visits and fill in symptom forms one week, one month, three months and six months after the surgical procedure.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
40
Surgical treatment of complex perianal fistula. Less tissue damage. Electrocoagulation source with 75% lower power. Better de-epithelialization of the intra-sphinteric tract. More precise closure of orifice. More consistent mucosal flap
Hospital Son Llatzer
Palma de Mallorca, Balearic Islands, Spain
RECRUITINGHealing rate
Healing will be measured if 4 criteria are present: no supuration or pain for more than a week, no open external fistulous orifice, no palpable trajectory, no internal fistulous orifice and no tract or collections in 3D endoanal ultrasound.
Time frame: six months
Postoperative pain
Pain measured in visual analogic scale (VAS). Scale: 0 to 10. Higher scores mean a worse outcome.
Time frame: one week
Global morbidity
Clavien Dindo Scale. Scale: 1 to 5. Higher scores mean worse complications.
Time frame: one month
Quality of life score
SF 36 questionnaire. 36 items. Higher scores mean a better quality of life.
Time frame: six months
Fecal incontinence
Measured in Wexner scale. Score 0 to 20. Higher scores mean a worse outcome.
Time frame: six months
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