ORIGINAL RESEARCH article
Front. Med.
Sec. Gastroenterology
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1589278
Evaluation of the RIFER procedure in treating high intersphincteric anal fistulas
Provisionally accepted
- 1Nanjing Hospital of Chinese Medicine Affiliated to Nanjing University of Chinese Medicine, Nanjing, Jiangsu Province, China
- 2Nanjing University of Chinese Medicine, Nanjing, Jiangsu Province, China
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Introduction: A high intersphincteric anal fistula is a common anorectal disease that is challenging to treat due to high recurrence rates and has the risk of sphincter damage, which can lead to incontinence. This study aimed to evaluate the efficacy and safety of the rectal incision, fistula excision, and reconstruction (RIFER) procedure for treating high intersphincteric anal fistulas. Methods: Twenty-six patients with high intersphincteric anal fistulas who were admitted to Nanjing Hospital of Traditional Chinese Medicine between September 2021 and March 2024 and underwent the RIFER procedure were included. Patients were followed up for 6 months, and treatment efficacy, recurrence, and postoperative complications after the RIFER procedure were assessed. Results: The surgical cure rate of patients treated with RIFER was 100%, with no recurrence or postoperative complications during the follow-up period. The average wound-healing time was 45.40 days. Functional scoring indicators, such as the visual analog and Wexner anal function scores, improved at different postoperative time points. After the RIFER procedure, the incision scar score of most patients (18 of 25) was 0, and none of the patients reported keyhole-like anal deformities. The mean hospital stay was 10.15 days. Conclusion: The RIFER procedure demonstrated remarkable efficacy and safety in the treatment of high intersphincteric anal fistulas, with no recurrence or postoperative complications. This procedure is suitable for treating high intersphincteric anal fistulas in clinical practice.
Keywords: RIFER, high intersphincteric anal fistula, functional outcome, complications, Retrospective study
Received: 07 Mar 2025; Accepted: 21 Apr 2025.
Copyright: © 2025 Ding, Xue, Miao, Zhu, Ye and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Xiaofeng Wang, Nanjing Hospital of Chinese Medicine Affiliated to Nanjing University of Chinese Medicine, Nanjing, 210023, Jiangsu Province, China
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