Modified surgical technique shows shorter recovery times versus traditional surgery for complex anal fistula

This randomized controlled trial enrolled 102 patients with MRI-confirmed complex anal fistula to compare two surgical approaches. The intervention group received internal opening downward displacement combined with external sphincter denudation and virtual hanging drainage, while the control group underwent traditional incision and hanging thread surgery. Patients were followed for 12 months, with outcomes including surgical parameters, anal function (Wexner score), quality of life (EQ-5D score), and recurrence.

The modified surgical technique demonstrated several procedural advantages over traditional surgery. Operation time was shorter in the treatment group (69.22 ± 32.81 minutes versus 77.33 ± 40.66 minutes). Wound healing time was also reduced (42.10 ± 3.65 days versus 47.54 ± 5.33 days), and hospital stay was substantially shorter (4.88 ± 1.84 days versus 9.94 ± 4.26 days). All differences were statistically significant (P < 0.05), though exact P-values were not provided.

Key limitations include the absence of reported safety data, adverse events, or discontinuation rates. The study did not report funding sources or conflicts of interest, and the primary outcome was not explicitly distinguished from secondary outcomes. While the modified technique shows promise for reducing recovery times, clinicians should interpret these findings cautiously until larger studies confirm these benefits and establish the safety profile of this approach.