What is Fistula?

Anal fistula surgery is no different from other surgical procedures in that there are potential risks and complications associated with it.There are several common complications that may arise:

• Infection: When incisions are made in the skin, any surgery carries some risk of infection. The same goes for the fistulectomy procedure. In some cases, when the fistula's path is too deep, the doctor may need to perform the surgery in stages. If so, there is a big chance that the fistula will spread throughout the body and cause a systemic infection. If you have an anal fistula infection, your doctor may prescribe antibiotics. If the infection is too severe, the patient may even need to be hospitalized and given intravenous antibiotics.
• Bowel incontinence:If fistula surgery is not performed by an experienced anorectal surgeon, there is a possibility that the anal sphincter muscles may be damaged. The anal sphincter muscles are responsible for maintaining the anus and controlling bowel movements. Either way, if the sphincter muscles are damaged, the strength of the anal muscles is impaired, which can lead to loose stools. This condition is known as bowel incontinence. Bowel incontinence is estimated to affect 3 to 7% of all patients undergoing anal fistula surgery.
• Anal fistula recurrence:Anal fistula recurrence: It is estimated that 7 to 21% of patients undergoing anal fistula surgery experience anal fistula recurrence after surgery. The chances of recurrence are ten times higher in the case of treatment of anal fistula with fibrin glue.

It takes 30-45 days to fully recover from anal fistula surgery. However, you will be able to return to your daily activities after resting for 1 or 2 days.

Ksharsutra treatment in piles can be done under local anesthesia and patient is discharged within an hour. Here no cut or stitches are taken. The ksharsutra is tied at the base of pile. So no need of general or spinal anaesthesia. After 8 to 10 days the piles get dry and shrink. They wash out during deification without any big wound.

Surgical

• Fistulotomy: In this procedure, the surgeon cuts along the fistula to open up the tract and make sure it heals as a flat scar. This method is not considered if the fistula passes through the sphincter muscles, as the risk of incontinence is too high.
• LIFT: In the LIFT or intersphincteric fistula tract ligation procedure, a cut is made in the skin over the fistula and the sphincter muscles are separated. The leather is sealed at both ends and trimmed to flatten.
• Advancement flap procedures: This procedure is considered if there is an increased chance of incontinence. Here, the fistula is cut and scraped, and the opening where the fistula enters the intestine is covered with flat tissue taken from the rectum.

Non- Surgical

• Fibrin Glue:In this procedure, the surgeon injects fibrin glue into the fistula, sealing it to promote healing.However, it is not an adequate substitution for surgery.
• Seton placement:In this procedure, a surgical thread, also called a seton, is inserted into the fistula and left on for several weeks. A wider seton is placed to drain the fistula, while a narrower seton is used to cut away inflamed tissue.
• Kshar Sutra: In this Ayurvedic procedure, a medicated thread is inserted inside the fistula path, which is then tied together. The thread removes the affected tissue and is replaced after a week.