Differences between minimally invasive surgery and traditional surgery for perianal abscess

Written by Yu Xu Chao
Colorectal Surgery
Updated on November 07, 2024
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In clinical practice, perianal abscesses are primarily due to infection and inflammation of the anal glands, which then leads to the formation of red and swollen masses around the anus, causing pain and swelling near the anus. If not treated surgically in a timely manner, it can lead to necrotizing fasciitis or anal fistulas.

Minimally invasive surgery for perianal abscesses mainly aims to minimize damage to the anal sphincter during the procedure. Techniques such as loop drainage can be employed to preserve it, whereas traditional surgery generally involves larger incisions, but provides better drainage and has a lower recurrence rate post-operatively. However, leakage or moisture in the anal area can occur after traditional surgery.

For minimally invasive surgery for perianal abscesses, there is a relatively higher recurrence rate since the drainage may not be as effective. However, the integrity of the anus post-surgery is better preserved and incidents of leakage are less frequent. The choice of surgical method should still be based on the severity of the perianal abscess.

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Written by Chen Tian Jing
Colorectal Surgery
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What should I do if the perianal abscess bursts?

Since a perianal abscess is an acute symptom of a local skin infection around the anus, during the acute phase of a perianal abscess, an abscess cavity and pus formation generally occur within about a week. As the disease worsens and progresses, the perianal abscess will rupture about a week later. If the perianal abscess ruptures, it may have already formed an anal fistula. A perianal abscess and an anal fistula represent two different stages of the disease, and both require surgical treatment. The main surgical treatment for anal fistulas is fistulotomy with seton placement, and care must be taken to drain and disinfect the local wound post-surgery to prevent pseudohealing of the wound.

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Written by Yu Xu Chao
Colorectal Surgery
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Differences between minimally invasive surgery and traditional surgery for perianal abscess

In clinical practice, perianal abscesses are primarily due to infection and inflammation of the anal glands, which then leads to the formation of red and swollen masses around the anus, causing pain and swelling near the anus. If not treated surgically in a timely manner, it can lead to necrotizing fasciitis or anal fistulas. Minimally invasive surgery for perianal abscesses mainly aims to minimize damage to the anal sphincter during the procedure. Techniques such as loop drainage can be employed to preserve it, whereas traditional surgery generally involves larger incisions, but provides better drainage and has a lower recurrence rate post-operatively. However, leakage or moisture in the anal area can occur after traditional surgery. For minimally invasive surgery for perianal abscesses, there is a relatively higher recurrence rate since the drainage may not be as effective. However, the integrity of the anus post-surgery is better preserved and incidents of leakage are less frequent. The choice of surgical method should still be based on the severity of the perianal abscess.

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Written by Chen Tian Jing
Colorectal Surgery
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How many days does the skin around an anal abscess fall off?

During the acute phase of a perianal abscess, if rubber band ligation surgery is performed, the duration of the rubber band falling off generally depends on the location of the lesion. For superficial local perianal abscesses, the rubber band typically falls off within one to ten days. For high-position complex perianal abscesses or those accompanied by anal fistulas, the falling off of the rubber band might take about ten days. In some cases where the rubber band falls off slowly, it may require a doctor's dressing change and assistance to weaken or detach the local rubber band. Do not pull off the rubber band yourself to avoid injuring the local sphincter, which could lead to decreased or abnormal tightness around the anus.

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Written by Chen Tian Jing
Colorectal Surgery
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Can you eat fish with a perianal abscess?

Patients with perianal abscesses should avoid eating seafood or consuming excessive amounts of seafood products. Because fish and seafood are considered to provoke symptoms in traditional beliefs, their overconsumption can lead to congestion and swelling of the local mucosa. Along with an acute infection of a perianal abscess, food may exacerbate the infection. Therefore, the diet of patients with a perianal abscess should primarily be bland. Additionally, once a perianal abscess is detected, it is necessary to perform an incision and drainage procedure for the abscess promptly, as well as a one-time debridement and radical surgery to prevent the further expansion of the abscess cavity or recurrent infection leading to the formation of anal fistulas.

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Written by Chen Tian Jing
Colorectal Surgery
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How should a perianal abscess be treated effectively?

During the acute phase of a perianal abscess, there is generally severe pain in the anal area, accompanied by redness and throbbing of the skin, and there may be a pus cavity or pus encapsulation under the skin. The treatment of perianal abscess is mainly surgical. The surgical method is incision and drainage, combined with a one-time radical surgery. If the infection involves the local sphincter or has already formed a clear fistula, further incision and ligation surgery may be required. After surgery, it is necessary to thoroughly disinfect and change the dressings of the wound to prevent excessive granulation or the formation of false healing at the local wound. Postoperative diet should consist mainly of light, liquid foods, and spicy and irritating foods should be avoided.