General Information
DEFINITION--Removal of an anal fistula, an abnormal tract extending from inside
the rectum to the skin outside of the anus.
BODY PARTS INVOLVED--Rectum; skin and underlying tissue around the rectum and
anus.
REASONS FOR SURGERY
- Repeated abscesses in the anal and rectal areas.
- Chronic drainage from a fistula.
SURGICAL RISK INCREASES WITH
- Stress.
- Poor nutrition.
- Recent illness.
- Obesity.
- Smoking.
- Use of drugs such as: antihypertensives; muscle relaxants; tranquilizers; sleep
inducers; insulin; sedatives; beta-adrenergic blockers; or cortisone.
- Use of mind-altering drugs, including: narcotics; psychedelics; hallucinogens;
marijuana; sedatives; hypnotics; or cocaine.
What To Expect
WHO OPERATES--General surgeon or proctologist.
WHERE PERFORMED--Outpatient surgical facility or hospital.
DIAGNOSTIC TESTS
- Before surgery: x-rays of lower gastrointestinal tract; colonoscopy (See Glossary).
- After surgery: Blood studies.
ANESTHESIA--General anesthesia by injection and inhalation with an airway tube
placed in the windpipe.
DESCRIPTION OF OPERATION
- An incision is made in the skin around the rectum. Abscesses are drained, if necessary.
- The fistula is located with a delicate probe, cut free of connective tissue and removed.
- The space left by the removed fistula is packed with medicated gauze. A bandage is
applied to control bleeding.
- The surgical wound is left open to heal from inside out.
POSSIBLE COMPLICATIONS
- Excessive bleeding.
- Surgical-wound infection.
- Slow healing or recurrence.
AVERAGE HOSPITAL STAY--0-3 Days.
PROBABLE OUTCOME--Expect complete healing without complications in 4 to 5 weeks
for small fistulas and up to 16 weeks for deeper ones.
Postoperative Care
† Use an electric heating pad, a heat lamp or a warm compress to relieve surgical--
wound pain.
- Take warm baths as often as needed to relieve discomfort. > Move and elevate legs
often while confined to bed to decrease the likelihood of deep-vein blood clots. >
Change bandages or sanitary pads 4 to 5 times a day or as directed by your doctor. >
Clean the rectal area with soap and water after bowel movements.
† You may use non--prescription drugs, such as acetaminophen, for minor pain.
† To help recovery and aid your well--
being, resume daily activities, including work, as soon as you are able.
- Avoid vigorous exercise for 6 months after surgery. > Resume driving 1 week after
returning home. > Resume sexual relations when your doctor determines that healing is
complete.
DIET--Clear liquid diet until the gastrointestinal tract functions again. Then eat a
well--balanced diet to promote healing, if your doctor does not prescribe a special
diet. Increase fiber and fluid intake to prevent constipation.
Call Your Doctor If
† Pain, swelling, redness, drainage or bleeding increases in the surgical area.
- You develop signs of infection: headache, muscle aches, dizziness or a general ill
feeling and fever.
- You experience nausea, vomiting or constipation.
- New, unexplained symptoms develop. Drugs used in treatment may produce side effects.
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