Low anal fistula

Anal fistula is a very common anorectal disease. It is very painful for patients to suffer from anal fistula. If you want to prevent anal fistula, you must develop good living habits, actively prevent constipation, and eat more fresh vegetables and fruits. The most common treatment for anal fistula is surgery. Will there be any sequelae after surgery for low-position complex anal fistula?

Are there any sequelae after surgery for low-position complex anal fistula?

Most of the sequelae of anal fistula surgery are caused by unprofessional surgeons or lack of proper postoperative care. Therefore, when we undergo anal fistula surgery, we must choose a professional hospital and physician. If we follow the physician's instructions for proper postoperative care, we can avoid the sequelae of anal fistula surgery.

What are the sequelae of low-level complex anal fistula surgery?

Anal incontinence: In clinical practice, complete anal incontinence after anal fistula surgery is very rare and requires repair surgery; what is commonly seen is incomplete anal incontinence and anal sensory incontinence, which can only be treated conservatively and by strengthening anal function exercises.

Wet anus or leakage of small amounts of loose stool: This is due to excessive scarring from surgery causing the anus to not close tightly, and patients often have a scar-prone constitution. Over time, the scars may soften and the sequelae may disappear. It’s just that this time period varies from person to person. For example, it will be longer for diabetic patients.

Anorectal stenosis: caused by complex fistulas and large areas of scar contracture.

How to treat anal fistula

The surgical principle is to completely incise the fistula and fully remove the scar tissue on both sides of the incision to ensure smooth drainage and gradual healing of the incision. This method is only applicable to low-position straight or curved anal fistulas. Here’s how it works.

Correctly explore the internal opening. The operation of finding the internal opening is the same as the hanging thread therapy. After finding the internal opening, pull the probe out of the anus. If the fistula is bent or has branches, the probe cannot enter the internal opening. Inject a small amount of 1% methylene blue solution from the external opening to determine the location of the internal opening, and then explore from the external opening with a slotted probe. Gradually cut the tract and explore until the internal opening is found. If the internal opening cannot be found after careful exploration, the anal sinus suspected of having a lesion can be treated as the internal opening.

The fistula was incised and the marginal tissue was fully removed. All the superficial tissues of the fistula were incised, from the external opening to the internal opening and the corresponding anal sphincter fibers. After the fistula is opened, check for branches, and if found, they should be opened. After the fistula is completely incised, the rotten granulation tissue will be scraped clean. Generally, there is no need to remove the entire fistula to avoid excessive wound size. Finally, trim the wound edges to make it into a "V" shape with a small bottom and a large mouth, so that the deep part of the wound can heal first.