How to cure anal fistula completely

Written by Chen Tian Jing
Colorectal Surgery
Updated on September 02, 2024
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The radical treatment of anal fistula mainly involves surgery, with the choice of surgery being the anal fistula cutting and ligation operation. This primarily utilizes a ligature or elastic band to loop through the local sphincter, thereby achieving slow cutting and drainage of secretions. Anal fistula is considered a local infectious lesion at the anus, and the fundamental principle of the surgery is to remove the local fistula tract and the wall of the fistula completely through cutting and ligation, and after thoroughly removing the local infection, fresh granulation tissue can regrow. Due to the prolonged location of the local lesion in anal fistulas, postoperative wound dressing and drainage are very important. The wound can be disinfected daily with povidone-iodine, and gauze impregnated with oil can be used for pressurized drainage to help facilitate the flow of local secretions.

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Written by Chen Tian Jing
Colorectal Surgery
1min 1sec home-news-image

Anal fistulas secondary to which disease?

An anal fistula generally originates from a perianal abscess, which is an infection focus formed near the anal sinuses in the local area of the anus. During its onset, there is obvious local redness, swelling, heat, and pain accompanied by the formation of a pus cavity containing pus. As the condition of the perianal abscess worsens, the local pus cavity will rupture and discharge pus, thus forming an anal fistula. After the rupture of a perianal abscess, its external opening cannot heal by itself, and there will be intermittent recurring discharge of pus. Therefore, it is necessary to carry out surgical treatment as soon as possible after the formation of an anal fistula, to prevent the enlargement of the local pus cavity or thickening of the fistula wall, which complicates later surgery and treatment and significantly impacts the patient's normal life.

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Written by Yu Xu Chao
Colorectal Surgery
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Is it better for the external opening of an anal fistula to be closed or not closed?

In clinical practice, it is generally best not to close the external opening of an anal fistula. Keeping the drainage unobstructed can prevent the infection from worsening or the formation of multiple branches. This is because when the fistula drains properly, the infectious secretions can flow out of the external opening. However, if the external opening does close, the infected tissues and secretions will accumulate within the fistula and then spread to the surrounding areas, forming branches and leading to an increase in the number of branches, thus creating a complex anal fistula and increasing the difficulty of future surgeries. Therefore, it is best not to close the external opening of an anal fistula. Clinically, the treatment for an anal fistula involves fistulectomy, which primarily involves removing the internal opening and the fistula. The external opening also needs to be treated. Postoperatively, medications such as erythromycin ointment gauze strips should be used for dressing changes.

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Written by Yu Xu Chao
Colorectal Surgery
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Is a second surgery for an anal fistula more difficult than the first one?

Relative to the initial procedure, a second surgery for anal fistula is more difficult. The main goal of anal fistula surgery is to remove the internal opening and the fistula tract completely to cure the condition. During a second surgery for an anal fistula, due to the previous operation, the internal opening may be unclear, and it can be difficult to distinguish between the fistula and scar tissue. This can lead to incomplete removal by less experienced surgeons, increasing the likelihood of the fistula recurring later. Therefore, for a second surgery on an anal fistula, it is essential to undergo the procedure in a specialized colorectal department at a provincial-level top-rated hospital. It is recommended to have a magnetic resonance imaging (MRI) of the anal region before surgery to ensure precise operation and complete removal of the internal opening and fistula tract. Proper postoperative dressing changes are also crucial to avoid infection and inflammation of the wound, which will help with normal recovery after the surgery.

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Written by Yu Xu Chao
Colorectal Surgery
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What are the consequences of not treating anal fistulas?

Since an anal fistula is caused by the infection and inflammation of the anal glands, it connects the rectum or anal canal with the skin around the anus, forming repeated abscesses, pain, and discharge of pus and blood around the anus. If an anal fistula is not treated, more fistula tracts will develop over time, and more of the muscles around the anus will become infected. This can even lead to high, complex anal fistulas, making surgical treatment later on more difficult and could easily lead to anal incontinence. Also, if an anal fistula is left untreated for a long time, there is the possibility of malignant transformation. Therefore, in clinical practice, it is recommended to undertake surgical treatment for anal fistulas as early as possible. The surgery for an anal fistula mainly involves the removal of the internal opening and the fistula tract, which is essential for a complete cure. Postoperatively, it is necessary to persist in changing dressings to avoid infection or pseudohealing at the wound site. Moreover, patients should be mindful of their diet.

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Written by Yang Dong
Colorectal Surgery Department
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Is the probability of anal fistula turning into cancer high?

An anal fistula, formed due to an anal gland infection, carries a higher risk of malignant transformation if the infection and inflammation are recurrent and persistent, particularly over a long period exceeding five years. Therefore, it is strongly recommended that anal fistulas exceeding five years should be given sufficient attention and surgical treatment should be pursued promptly to prevent malignancy.