Definition | |
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Inclusion criteria | High trans-sphincteric (> 50% of external sphincter), supra-sphincteric or extra-sphincteric fistulas The fistula confirmed and classified by an MRI Seton (> 6 weeks) prior to fat injection Informed, written consent |
Exclusion criteria | Anovaginal fistula Active sepsis IBD, immunodeficiency, prior pelvic irradiation and fistula caused by malignancy Insulin dependent diabetes More than 4 prior attempts of closure with sphincter saving procedures Tobacco smoking or nicotine substitution of any kind 8 weeks prior to fat injection Pregnancy Psychiatric disorders BMI ≥ 35 or BMI < 20 kg/m2 Active tuberculosis Patient less than 18 years Unable to undergo MRI |