Ligation and adhesive-based techniques for complex anal fistulas show reduced fecal incontinence and pain, along with improved quality of life, compared to traditional seton methods.

• Adipose-derived stem cells plus fibrin glue and video-assisted anal fistula treatment with ligation of the intersphincteric fistula tract demonstrate the best outcomes for fecal continence.
• Recurrence rates are significantly lower with adipose-derived stem cells (RR 0.02) and acellular dermal matrix (RR 0.08) compared to setons.

Consider these findings when selecting surgical options to enhance patient outcomes.