Anal fistulas commonly occur in people with a history of .
USMLE® Step 1 style questions USMLE
USMLE® Step 2 style questions USMLE
A 43-year-old man comes to the office for a pre-surgical consultation for trans-sphincteric fistula-in-ano. Examination shows a fistula tract that tunnels through both the external and internal anal sphincters high in the upper 1/3rd of the external anal sphincter muscle. Which of the following is the most appropriate treatment modality for this patient?