The final evaluation and classification of the surgical treatment of the primary anorectal cryptoglandular intermuscular (Intersphincteric) fistulous abscess and fistula

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Abstract
The series reported included almost 800 cases extending over a period of 25 yr. A reorientation of the teaching regarding anorectal suppurative lesions of cryptoglandular origin was attempted. At present, the emphasis in both classification and surgical treatment, give priority to the resultant anal fistula. This should be reversed and significance should be attached to the original acute lesion-like fistulous abcess-which must take absolute precedence. The corresponding fistula is a sequel. The iatrogenic complications of treatment of both the abscess and its fistula necessitate a separate classification to uncomplicate the surgical approach to this subject. This operation should be done by the experienced, specialized physician, the proctologist or anorectal surgeon to obtain the best results. The general surgeon is not likely to attain sufficient proficiency in this field.

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