Outcomes of a New HYBRID Technique Using Self-cutting Elastic Setons for Anal Fistulas: A Single Institution Retrospective Analysis

Abstract Background: An anal fistula is a tiny tunnel that forms between the end of the colon and the skin near the anus. It usually results from an infection close to the anus that causes an abscess in the surrounding tissue. Anal fistulas were previously treated by fistulotomy. However, sphincter damage and a high recurrence rate were concerns associated with this surgery. Numerous developments have occurred in the treatment of anal fistulae. The Ligation of Intersphincteric Fistula Tract (LIFT) technique is one such development; nonetheless, it carries a recurrence risk that necessitates alternative treatments. Materials and Methods: We have modified the LIFT method by incorporating self-cutting elastic setons for the treatment of anal fistula. This retrospective analysis evaluates the efficacy of the HYBRID method at a single institution, with a focus on reducing post-LIFT recurrence. Results: Applying the HYBRID technique significantly revolutionised the treatment of post-LIFT recurrences, with an unprecedented success rate of zero recurrence in all treated cases. Since there is a statistically significant difference in the non-recurrence rates between the two treatment methods, the fact that the confidence interval does not include 1 suggests that the finding is statistically significant. Conclusion: We concluded that the HYBRID approach has revolutionised the treatment of anal fistulas and established new benchmarks for post-LIFT surgical care.