The aim of surgery is to cure the fistula as the medication alone will not cure it. Fistulas A fistula occurs when two organs or vessels form an abnormal connection. Anal fistulas occur when the skin around the opening of the anus forms an abnormal connection with the surface of the anal canal. An anal abscess is a major cause of fistula. Causes of Fistulas A fistula can occur when the mucus gland within the anus becomes chronically inflamed, causing an abnormal connection between the anal canal and the opening of the anus that does not heal. This can cause continuous or occasional discharge of pus, blood, and/or mucus.
To help surgically close fistulas that arise in various parts of the body. Fistulas most commonly occur at the anus and are known as ano-rectal fistulas
Surgery is usually a definitive treatment of fistulas.
As with all other surgeries, this procedure carries the risk of bleeding and infections, all of which will be minimized by your primary care doctor
Surgery of Fistula fistulotomy involves the insertion of a probe into the fistula and using a scalpel or cautery to open up the abnormal connection. The wound must then be cared for until it heals from the inside out and tissue grows into the open wound. A fistulectomy involves the removal of the fistula. Then some tissue from the rectum is used to close and repair the sphincter muscle. LIFT (ligation of the intersphincteric fistula tract) is the technique to close the fistula without injury to the anal sphincter.
You will be expected to fast from midnight the before your surgey and are not allowed to drink 4 hours before the procedure. Your doctor will require you to stop taking certain medications such as anti-coagulants and NSAIDs to prevent complications during the procedure
It may take 3-12 weeks to fully recover from a fistulotomy. Your doctor will send you home with instructions to keep the wound clean and packed with gauze. Packing it with gauze will help prevent your skin from healing over the wound, which could cause another fistula to form. You will be expected to rest 24 hours after the procedure, though you should resume your normal diet following the surgery. Ask family members or friends to help you out around the house, and plan to take at least a day off of work. You should avoid strenuous activities, including exercise and heavy lifting, for at least a week. Your doctor may recommend waiting longer to resume all of your normal activities. You may experience some cramping and nausea immediately following the procedure. You may also experience constipation as a side effect of your pain medications. If you experience this, talk to your doctor about using a stool softener, which can help you resume normal bowel function.
Generally, surgery for anal fistula are safe procedures, but like any other surgery, there are always associated risks, including: -Increased pain or inflammation. -Excessive bleeding. -Constipation lasting more than three days, even after taking laxatives. -Difficulty urinating or passing stool. -Fever of more than 38 degrees Celsius and/or chills. -Nausea and/or vomiting. -Too much of the sphincter muscle being excised, resulting in bowel incontinence.
How is a fistolotomy different from a fistulectomy?
A fistolotomy is usually performed as an outpatient procedure that involves opening and draining the fistula to help it heal. The procedure takes approximately an hour to perform. A fistulectomy on the other hand involves removing the fistula and the surrounding tissue of the affected organ.