Anal Fistula Surgery

Anal abscess is a debilitating and painful condition that arise due to infection within the glands of the anal canal. It can also arise as a result of Crohn’s Disease. Abscesses are treated by incision and drainage under general anaesthesia to allow full assessment of its involvement of the anorectal spaces and its relation to the anal sphincter complex.

Anal fistula is an abnormal connection between the lining of the anorectum with the abscess cavity and the external perianal skin. When an abscess is associated with a fistula, the condition does not resolve by simple incision and drainage.

Techniques for Anal Fistula Surgery

The appropriate surgical technique to treat the anal fistula is dependent on the length of the tract, the extent of involvement of the sphincter muscles and the location of the tract. The aim of treatment is to eradicate anorectal sepsis and infection, and preservation of continence.

The most straight forward option to treat a low anal fistula with a short tract would be a laying open technique by fistulotomy.

When there is more sphincter muscles involved i.e. internal and external anal sphincters, setons may be placed to promote drainage and reduce anorectal sepsis before definitive fistula treatment. At times in situations where the tracts are longer, involved more sphincter muscles, multiple surgeries may be required to cure the fistula.