When it comes to the treatment of anal fistulas, it all boils down to one phrase – complete surgery. Whether high or low, simple or complex, anal fistulas can be well resolved through surgery. With the increase in anal surgery in primary care hospitals, we have seen a decrease in the number of simple and low anal fistulas, but more patients with high and complex fistulas, often having been operated on once or twice. This type of fistula is what we generally call a refractory fistula. The first is that the fistula is complex, not easy to explore and easy to recur after surgery; the second is that surgery is easy to injure the anal sphincter, causing the patient’s anal incontinence, even if the fistula is explored, there is no way to start. After much thought and practice, I was able to basically probe the fistula clearly. I use is a probe, plus a hand feel, and the eye can see it, mainly by experience. It is not impossible to state theoretically, but in practice the nuances can only be obtained by repeated experience. For protecting the anal sphincter, the choice of the location of the incision is crucial and this has not been talked about, in fact a good incision and orientation of the incision can make the removal of the fistula easy and complete. For slender and curved fistulae, after thorough debridement, we have treated them with bioprotein gel sealing method with very satisfactory results, which can protect the anal sphincter well, reduce the patient’s pain, shorten the course of treatment and reduce the cost. Now there are more advanced filling materials to block the fistula, these are new biomaterials, which are more expensive and are not used much in clinical practice. Regardless of the method used, one basic principle is that the fistula should be thoroughly explored and debrided.