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Invited lecture / 2021 Meeting of the colorectal surgeons of Russia Anal fistula is one of the most common proctologic disorders treated by surgeons. Anal fistula is a tunnel communication often occurring between the anal canal and the skin. The only proven treatment for anal fistula is surgical intervention. A variety of surgical techniques have been developed over the last century. The aim of surgical intervention is to eradicate the anal fistula, and minimize recurrent disease preserving anal continence function by minimizing complications. In this lecture, presented virtually to the meeting of the colorectal surgeons in Russia, Professor Maher A. Abbas discussed the risk factors that can lead to failure of operative intervention. Professor Maher A. Abbas is an American board colon and rectal surgeon with extensive experience in the treatment of anal fistula. He has operated on thousands of patients and has taught surgeons in various countries of the world about anal fistula. He currently cares for local and international patients in Dubai, United Arab Emirates. Visit Dr Maher A. Abbas' website at https://drmaherabbas.com/ Fellow, American College of Surgeons Fellow, American Society of Colon and Rectal Surgeons Diplomate, American Board of Surgery Diplomate, American Board of Colon and Rectal Surgery