Perianal fistula surgery
What is it?
When is this procedure indicated?
The procedure is indicated in perianal fistulas. Perianal fistulas are a communication between the anorectal canal and the perianal area. The most effective classification divides them into simple fistulas and complex fistulas. The most frequent cause are cryptoglandular abscesses at the level of the pectinate line (anatomical junction between the anus and rectum). In other cases they are secondary to chronic anal sacred fires, and finally they can be caused by Crohn's disease (perianal Crohn's).
How is it performed?
Perianal fistula surgery is always minimally invasive. Much depends on the type of fistula, its pathway, and the amount of sphincter muscle they pass through. Often, this is a 2-stage surgery: in the first, the fistulous passage is identified, curettage is performed, and then a Loose or Draining Seton is placed. The next step, after a few weeks, will be the definitive treatment of the fistula, and this procedure can be performed with LASER technology, biological material, stem tissue or with the simple surgical removal of the fistula (in the simplest cases).
Recovery
Inpatient stay will always be one night. The resumption of work activities after less than a week.
Short-term complications
Scarring outcomes of variable extent depending on the particular characteristics of the disease and the scarring attitudes of the person; recurrences at variable distance of time after surgery; postoperative bleeding that rarely may require surgical revision; difficulty in retaining gas or liquid stool that in most cases regresses within a few weeks; postoperative pain: generally controllable with common analgesics; urinary retention, especially in patients with prostate disease and may require the application of a urinary catheter in the first 12/24 hours after surgery.
Long-term complications
Continence disorders. Recurrences of fistula.
Where do we treat it?
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