Comparative Study Between Fistula Rerouting Technique and Ligation of Intersphincteric Fistula Tract (LIFT) Technique in Treatment of High Perianal Fistula.
The goal of this clinical trial is to compare two different surgery methods for treating a complex type of anal fistula. This condition is an abnormal tunnel connecting the inside of the anus to the skin nearby. The main questions the study aims to answer are: Which surgery has a lower chance of the fistula coming back (recurrence)? Which surgery has a lower chance of causing problems with bowel control (incontinence) after healing? Researchers will compare two surgery groups: Group 1: Fistula Rerouting Technique - a two-step surgery that moves the fistula tract to a safer area before opening it. Group 2: LIFT Technique - a surgery that ties off and closes the fistula tract from between the anal muscles. Participants will be randomly assigned by a computer to one of these two surgery groups. This helps ensure the comparison between the two surgeries is fair. Participants in this study will: * Have tests before surgery, including an MRI scan, to confirm they have the specific type of fistula being studied. * Undergo one of the two planned surgical procedures. * Attend follow-up visits after surgery at 1 week, 2 weeks, 1 month, and 3 months. * Be checked during these visits for wound healing, pain, infection, and bowel control. * Have another MRI scan if the fistula is suspected to have come back.
• Adult patients (age 20-65 years) presenting with a high perianal fistula, defined as:Trans-sphincteric fistula tract traversing the upper two-thirds of the external anal sphincter, Or Extrasphincteric fistula.
• Patients with recurrent perianal fistula.
• Ability to provide informed consent.