Sphincter-Sparing Techniques in the Treatment of Rectal Fistulas in Diabetic Patients

Relevance. Chronic rectal fistulas in patients with diabetes mellitus (DM) represent a challenging clinical scenario due to delayed wound healing, increased risk of infection, and higher recurrence rates. These complications are associated with microangiopathy, neuropathy, and impaired tissue regeneration characteristic of diabetes. Traditional surgical techniques such as fistulotomy or fistulectomy do not always yield satisfactory outcomes in this category of patients, which necessitates an optimized treatment approach.