Fistulotomy With or Without Marsupialization for Treatment of Simple Anal Fistula

Inclusion Criteria: * Both genders * Age: 18-65 years * All Patients with primary simple anal fistula (subcutaneous, intersphincteric, or low trans-sphicnteric involving less than 25% of external anal sphincter fibers). Exclusion Criteria: * High trans-sphincteric, extra-sphincteric, supra-sphincteric, secondary. * Recurrent anal fistulas. * Patients associated with anorectal pathology such as anal fissure, hemorrhoids, rectal prolapse, neoplasm, solitary rectal ulcer, inflammatory bowel diseases and TB. * High risk patients according to ASA (American society of anesthesiologists ) * Any degree of incontinence. * Patients with previous anal surgery.