EUS, sometimes complemented with probing, is well comparable to bodycoil MRI in classifying and describing the topography of an anal fistula.

Surgery for anal fistula with excision and advancement flap has a fairly high initial recurrence rate but a good final success rate. A decrease in continence is seen also after this kind of surgery for anal fistula. Manometric results suggest that this is associated with an impaired internal anal sphincter function.

There was no statistically significant effect on perineal wound complications or cancer recurrence following the local administration of gentamicin-collagen during APR.

This prospective randomized trial shows that sinus excision and primary closure results in faster healing than laying open does, but there is no difference in healing rate after 1 year. The laying open procedure is minimally invasive with small risks for the patient, and it might therefore be considered more frequently as the first choice of treatment (www.clinicaltrials.gov. Unique identifier: NCT00997048).