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For anorectal fistulae, the surgeon begins by identifying the internal and external opening of the fistula. The external opening is usually on the patient's skin and can be identified in clinic. The internal opening is within the anus, and can be found while the surgeon examins the anorectal columns
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As described above, when a fistulectomy is performed to remove an anorectal fistula tract that involves the anal sphincters, a common complication that may occur is fecal incontinence. The degree of incontinence can be measured using the Wexner score, which can allow surgeons to monitor the
105:, the surgeon then cores out the tunneling tract. At this point, the surgeon inspects the anal sphincters and closes any defects that were made during the procedure. The wound can then be left open to heal or closed by approximating the tissue back to its anatomic position with sutures.
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placement, where a rubber band seton is passed through the tract and left post-operation as a means to allow drainage of the fistula, fistulectomies are considered to be a more radical approach. The total removal of a fistula may damage nearby structures in the process.
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Based on guidelines published by the
American Society of Colon and Rectal Surgery (ASCRS) in 2016, simple and complex anal fistulas were to be treated by fistulotomy or rubber band seton placement with fistulectomies being a secondary option.
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In practice, fistulectomies are primarily performed by colorectal surgeons to treat anorectal fistulous tracts, as fistulas commonly emerge in the anorectal region. In this case, fistulectomies may compromise a patient's
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Fistulectomy can be considered in non-anorectal fistulas as well. In these circumstances, a fistulectomy may be the best option for the removal of a patient's diseased soft tissue.
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Bocchi, Maria
Beatrice; Cianni, Luigi; Perna, Andrea; Raffaele, Vitiello; Greco, Tommaso; Maccauro, Giulio; Perisano, Carlo (2020-12-30).
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while the patient is under anesthesia. A methalyne blue dye or a peroxide solution may be used to aid with this process.
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As with other surgeries, fistulectomies may also pose other complications such as delayed wound healing and infection.
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427:"One stage fistulectomy for high anal fistula with reconstruction of anal sphincter without fecal diversion"
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Farag, Ahmed Farag Ahmed; Elbarmelgi, Mohamed Yehia; Mostafa, Mahmoud; Mashhour, Abdrabou N. (2019-08-01).
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Once the openings of the tract are found, a thin metal probe is strung through. Using scissors or
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157:"Definition of FISTULA"
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109:Possible Complications
403:www.sciencedirect.com
187:"Anorectal Fistula"
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