[Chronic postoperative rectal fistulae. Treatment by transanal colo-anal anastomosis. Apropos of 4 cases].
In a few cases, the postoperative rectal fistulas progress towards chronicity despite correct treatment and left iliac derivation. In 4 cases of such fistulas (3 females and 1 male, mean age 46 years), developed after rectal surgery and persisting for 2 to 16 months in young subjects, in good general condition and with a good long-term prognosis, we performed rectal resection with transanal colo-anal anastomosis according to the Parks technique. This procedure led to healing of the course of the fistulas, then closure of the derivation anus in the 4 patients. The functional results proved to be satisfactory, following short-term rehabilitation with biofeedback. After discussing the other surgical possibilities, the authors estimate that such a radical cure must be decided upon without delay, in case of chronic rectal fistula.