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ANAL-FISTULA REMOVAL

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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