An anal fistula is a communication that develops between the anal canal, and the skin near the anus.The end of the fistula can appear as a hole in the skin around the anus.
Complex fistula – Is a fistula which has diverse tracts with interlinking connections.
Include Irritation, pain and discharge of pus around the anus. Sometimes a patient with an infected fistula could have a fever.
The Diagnosis is usually by symptoms, physical examination, proctoscopy. Sometimes an MRI to identify the different tracks may be required.
Medicines often times do not help in the healing of a complex fistula. However, medicines may help in the treatment of an infection that may be associated with the fistula.
Setons are threads that are used to drain the fistula usually in a high anal or a complex one. The threads usually made of non-absorbable material can be used to gradually cut the anal muscle or sphincter if the fistula in transphincteric.
A complex anal fistula is difficult to manage due to the many tracts involved. Surgery needs to be extensive and thorough.The Holmium Yag Laser has revolutionized complex anal fistula surgery by making it relatively simple.The Yag laser beam cuts tissues and coagulates without touching. Hence lateral spread of current is very minimal. This also promotes quick healing and recuperation is kept to the minimum.
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