The Author Replies

摘要

To the Editor-I appreciate the comments of Drs. Hammond and Lunniss and their insights into closure of complex anorectal fistulas. Like most surgeons, I subscribe to the cryptoglandular theory of fistula formation; however, I am more circumspect regarding epithelialization of the tract. The development of the plug arose from previous research performed by us that involved inserting a ureteroscope into the fistula tracts to "look into the belly of the beast," so to speak. As Drs. Hammond and Lunniss (and several other researchers) point out, we frequently saw side-tracts extending from the main fistula. What was more striking was the consistent appearance of the primary opening as a well-defined, mature "hole."