Question:medium

All of the following are sphincter-preserving surgical techniques for anal fistula EXCEPT:

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Which procedure excises the whole tract and therefore cuts muscle?
Updated On: Jun 25, 2026
  • LIFT (Ligation of Intersphincteric Fistula Tract)
  • FiLaC (Fistula-tract Laser Closure)
  • VAAFT (Video-Assisted Anal Fistula Treatment)
  • Fistulectomy
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The Correct Option is D

Solution and Explanation

Anal fistula surgery is judged largely by continence outcomes, because the tract often crosses sphincter fibres. Modern minimally invasive options were specifically designed to avoid cutting muscle.

$\textbf{LIFT}$ works in the intersphincteric groove, ligating the tract on either side without sacrificing sphincter bulk. $\textbf{FiLaC}$ delivers $360^\circ$ laser energy that shrinks and seals the tract lining while the muscle stays intact. $\textbf{VAAFT}$ uses direct endoscopic visualisation to destroy the tract and securely close the internal opening, again without dividing sphincter.

By contrast, $\textbf{fistulectomy}$ surgically excises the fistula as a block of tissue; because the tract physically runs through sphincter, removing it typically sacrifices muscle and threatens continence. It is therefore the odd one out.

\[\boxed{\text{Fistulectomy is NOT sphincter-preserving}}\]
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