Cutting of the Intersphincteric Space for High Anal Fistula: Functional Preservation and a Predictive Model for Postoperative Anal Incontinence

COIS represents a functionally optimized approach for HAF, balancing radical cure and sphincter integrity. The predictive model integrating systemic biomarkers advances personalized risk assessment, guiding surgical decision-making for patients prioritizing continence. These findings underscore the importance of metabolic and inflammatory profiling in prognostication, shifting the paradigm from anatomy-driven to function-preserving strategies.