Fistulectomy : Procedure, Benefits & More

Overview

Anal fistulas can be treated surgically with a fistulectomy. An anal fistula is an uneven opening that connects a pus-filled abscess inside the anus to an opening in the skin surrounding the anus. Fistulas can cause significant discomfort and agony. With a fistulectomy, you can be certain of an efficient approach to gain relief from your symptoms and the fistula that is causing them.

What Is Fistulectomy?

Fistulecomy is a surgery to fix fistulas in your body, most commonly an anal fistula. The procedure involves removing the fistula tract as a whole (entirely). This procedure is done under general or spinal anesthesia. Though healing takes time, fistulectomy is much more efficient than other procedures like fistulotomy. 

Fistulotomy and fistulectomy are procedures to treat a fistula - the difference from fistulectomy is that in fistulotomy, the surgeon will not remove any tissue, and the two ends of the fistula will be closed and remain attached to the organs, whereas in fistulectomy, the surgeon removes the entire fistula tract. The chances of post-operative complications are also low in the case of fistulectomy.

When Is A Fistulectomy Recommended?

Fistulectomy is the primary treatment offered to people with fistulas in the anus. An anal fistula is an abnormal tract connecting a pus-filled abscess in the anus to the skin outside. 
Fistulectomy is recommended when you suffer from symptoms of anal fistula like:

• Pain
• Bloody discharge from the anus
• Constant itching at the anus
• Chronic diarrhea
• Stool incontinence

You may develop fistulas if you suffer from a chronic intestinal disease like Crohn’s. Fistulas also develop if you have had abdominal surgery or have been exposed to chemotherapy as a part of cancer treatment. Fistulectomy is the ideal form of treatment in such cases.

How To Prepare For A Fistulectomy?

Fistulectomy is a surgery performed to help you get rid of the fistula in your anus. The surgery aims to remove the fistula tract entirely, not just plug or seal the openings. Here is how you can prepare for a fistulectomy procedure.

Before The Procedure:

• Your surgeon will carefully evaluate your case and perform a rectal examination.
• Your surgeon will suggest tests like an endoscopic ultrasound and an MRI that give high-definition pictures of the course of the fistula tract. This helps to plan the surgery better.
• You can ask your surgeon to explain the procedure's details, outcome, and prognosis. You will be asked to sign an informed consent form agreeing to proceed with the surgery.
• Discuss your medical history with your surgeon and inform him about-
  • All the medications that you are currently taking for your health conditions
  • Any dietary supplements and herbs that you are taking
  • Allergies towards medicines, if any.
• You will be advised of certain tests before you go in for surgery. These include routine blood tests and imaging tests like CT scans, MRI, USG scans, Fistulogram, etc. 
• You will be asked to stop medications like blood thinners (to prevent excessive bleeding during and after surgery) a week before surgery.
• On the day of the surgery, you will be asked to fast for a minimum of 12 hours before the surgery.
• You will be asked to arrange for a friend or relative to drive you home after the surgery is completed.

During The Procedure:

• On the day of the surgery, you will be advised to maintain a fasting period of a minimum of 12 hours.
• An IV line will be attached to a vein in your hand. This helps to keep administering fluids into your body.
• You will be given an enema to help empty your bowels.
• Your surgeon may use general or spinal anesthesia for the procedure.
• A contrast dye is injected through the outer opening of the fistula through a long, thin tube known as a fistula tube. 
• Once the dye is inserted, an imaging test like an X-ray or MRI is performed. This gives the surgeon a clear view of the course of the fistula.
• After the fistula tract has been identified (the beginning of the tract and its end), your surgeon will cut it out by making large to medium-sized incisions around your anal region.

The entire procedure takes about forty-five minutes to an hour to get completed. Unless complications develop during or after the surgery, you will be allowed to go home once the effects of anesthesia wear off. It will take about four to six weeks to heal and about 9 weeks to recover completely from a fistulectomy surgery.

After The Procedure:

• Once the procedure is completed, you will be shifted to the recovery room. Here your vitals, like your pulse rate, respiratory rate, temperature, and blood pressure, will be monitored.
• You will be allowed to go home when your vitals are stable and the effects of the anesthesia have worn off.
• You will feel pain and discomfort in your anal area for several days after the surgery.
• Pain medications and antibiotics to prevent infections will be prescribed.
• You will be sent home with details on post-operative wound care and a comprehensive list of things to take care of concerning your diet and physical activity.

Must Do Things To Boost Recovery After Fistulectomy

It will take a period of four to six weeks for you to heal completely from a fistulectomy. You can be up and about a week after surgery, but remember that the wound is still fresh, and you need to take all the necessary care.
Here is how you can care better for your wound after surgery and speed up the recovery time.

• Avoid strenuous activities for 1-2 weeks after surgery. Take adequate rest. You may be able to get back to work the next day, but you will end up feeling exhausted very quickly. Hence it is advisable to take things slow.
• Take frequent ‘Sitz baths’ to ensure perianal hygiene. This kind of therapy requires you to sit in a shallow basin or a tub filled with warm water. Topical antibiotic medications like betadine solution can be added to warm water for protection against infections. A sitz bath is beneficial for the following reasons-
  • It helps to relieve the pain, itching, and discomfort in the anal region
  • It helps reduce swelling, if any
  • It improves blood flow to the anal tissues by relaxing the anal sphincter muscles, thus promoting healing.
• Place a small tool beneath your feet when you need to pass stools. This helps to reduce the pressure on your pelvic muscles.
• After every bowel movement and Sitz bath, pat dry the area well. Any leftover moisture will harbor infective germs to breed and flourish.
• Keep up your nutrition levels. Preferably eat bland food for a couple of weeks. Avoid spicy, oily, and salty food. Include a lot of fibrous food in your diet as they help in the free motions of the bowels.
• Stay hydrated by drinking adequate amounts of water.

Why Choose Medfin?

Surgery can be a daunting aspect, and feeling anxious is absolutely normal. The massive amount of information you can get from the internet may confuse you even more. This is where Medfin can help. Leave us the hefty task of finding the best hospital, the finest doctor, and the latest procedure at the lowest cost. Let us take charge while you sit back and focus on your health and recovery. Think surgery! Think Medfin!