Smoking impairs rectal mucosal bloodflow--a pilot study: possible implications for transanal advancement flap repair.

Transanal advancement flap repair has been advocated as the treatment of choice for trans-sphincteric perianal fistulas, because it enables the healing of almost all fistulas without sphincter damage and consequent continence disturbance. After initial promising reports, recently less favorable results have been reported. It remains unclear why there is such a large variety in the reported healing rates.