Anal Fistula...
Q How is Fistulectomy/Fistulotomy
done ? What are the advantages and disadvantages of this
procedure?
Oldest and the best studied of all the methods. In this surgery,
the fistula tract is laid open by cutting out the whole tract with knife
[Fistulotomy] or the fistula tract is totally taken out[Fistulectomy]. The
resultant wound is generally not closed and left open to heal of its own. This
way the chances of recurrence are
decreased.It is considered as a good option for Low Fistulas but is not
recommended for High fistulas.
ADVANTAGES
High success rates in Low Fistulas
DISADVANTAGES
·
Pain-This surgery leads to a large wound from the anal
opening to the buttock . Understandably this leaves the patient with lot of
pain in the post operative period.
·
Invasive- The procedure is associated with a lot
of cutting ,scarring and distortion of anatomy.
·
Long Hospitalization- The patient generally needs
hospitalization for 4-8 days or even longer.
·
High morbidity- The patient requires dressings for 4-6
weeks and is obviously off the work for this time.
·
High recurrence rates-. In spite of all these difficulties,
this surgery is associated with a high recurrence rate.
·
Risk of Incontinence- The procedure has a definite risk of
incontinence especially in high fistulas.
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