Is the recovery from a second anal fistula surgery quick?

Written by Yu Xu Chao
Colorectal Surgery
Updated on December 25, 2024
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Whether the recovery from a second surgery for anal fistula is quick primarily depends on whether the surgical wound is infected and bleeding, and it is also directly related to the patient's own immunity and the size of the wound.

Generally, if the wound from the second surgery is relatively small and the patient does not have diabetes, tuberculosis, or inflammatory bowel disease, then the postoperative recovery tends to be quicker. Moreover, the patient should eat foods rich in high-quality protein and persist in changing dressings to avoid infection and bleeding of the wound, which also facilitates recovery after anal fistula surgery.

However, if the wound from the anal fistula surgery is larger and the second procedure involves the seton technique, and since the patient's second surgery is for a high complex anal fistula, the recovery time is relatively slower. Additionally, if the patient has diabetes or inflammatory bowel disease, this will directly affect the postoperative recovery.

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Written by Yu Xu Chao
Colorectal Surgery
1min 7sec home-news-image

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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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 Chen Tian Jing
Colorectal Surgery
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Which is more serious, anal fistula or hemorrhoids?

Anal fistulas and hemorrhoids are two different types of common colorectal diseases; neither can be said to be more severe than the other, as the severity of each disease depends on its progression and extent. If it's a simple superficial anal fistula, the severity is generally mild, primarily treated with surgery. However, if a high, complex anal fistula is present, in addition to surgery, a comprehensive pelvic MRI examination is also required to rule out any infections in the deep sphincter and ischioanal fossa. The severity of hemorrhoids primarily involves circular mixed hemorrhoids, or those accompanied by incarceration. If circular mixed hemorrhoids with incarceration occur, it is advisable to undergo surgical treatment as soon as possible to avoid necrosis. If hemorrhoids result in persistent and significant rectal bleeding, surgery should also be performed promptly to prevent anemia in the patient.

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Written by Chen Tian Jing
Colorectal Surgery
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Can anal fistulas be left untreated indefinitely?

If a patient is diagnosed with an anal fistula, it must not be left untreated. If an anal fistula is not actively treated over a long period, it can easily lead to thickening of the fistula tract or an increase in branching. Moreover, after long-term repeated inflammatory stimulation, some fistula tracts are prone to malignant transformations. Therefore, it is recommended that patients with anal fistulas seek symptomatic treatment as soon as they are diagnosed. The primary method of treating anal fistulas is surgical. The main surgical approach for an anal fistula is fistulotomy with seton placement, which involves removing the local fistula tract wall while preserving the function of the patient's sphincter muscle. After the surgery, patients need to follow a light diet to avoid an increase in local secretions, which can lead to inflammatory stimulation and even the recurrence of the anal fistula.

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Written by Deng Heng
Colorectal Surgery
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Can anal fistula be completely cured?

Anal fistulas rarely heal naturally, and surgery is the only treatment method to achieve healing. The reasons are as follows: Aside from an external opening on the skin around the anus, an anal fistula also has a primary infectious internal opening in the anal crypt. The two openings are interconnected, allowing bacteria and intestinal contents to enter the fistula tract through the internal opening, leading to recurrent infections. Persistent inflammation often prevents pus from draining through the external opening. There are complex relationships between the fistula and the sphincter muscles, and the frequent contraction and relaxation of the sphincter muscles can compress the tract, making it easy for pus to remain and cause infection. Therefore, surgery is necessary to completely cure an anal fistula.