Simple anal fistula

Anal fistula is a surgical procedure for non-surgical treatment of low anal fistula that does not heal for 3 months. It is also suitable for tuberculous anal fistula and no systemic active tuberculosis.

Treatment of diseases: anal fistula

Indication

1. Non-surgical treatment of low anal fistula that does not heal for 3 months.

2. Tuberculous anal fistula, no systemic active tuberculosis.

Contraindications

1, with systemic diseases, can not tolerate surgery.

2, local infection, not suitable for surgery.

Preoperative preparation

1. Patients with acute infection should control the symptoms, and take a bath with 1:5000 potassium permanganate warm water, until the acute inflammation subsides before surgery.

2. Tuberculous anal fistula, 2 weeks before surgery, anti-tuberculosis drugs were used. The patient had no symptoms of tuberculosis poisoning.

3. Enter the fluid diet 1 day before surgery.

4. Enema with soapy water 2 to 3 hours before surgery.

Surgical procedure

1. Position: The position of the stone.

2. Explore the location of the incision: observe the position and shape of the external orifice, and estimate the direction and depth of the fistula. First use the probe to gently penetrate from the outer mouth along the direction of the twisted tube, through the entire fistula, straight to the inner mouth. During the exploration, a finger can be inserted into the anal canal to sense the position where the probe passes. After the tip of the probe is pierced through the inner mouth, the tip can be clamped with a hemostat, or the probe can be bent to pass the tip out of the anus to prevent the probe from slipping off. If you can't find the inner mouth, you can put a dry gauze in the rectum, inject 2 to 3 ml of methylene blue from the outer mouth, pull out the gauze, observe the position of the blue stain, to determine the position of the inner mouth, and then insert the probe.

3. Cut the fistula: from the inner mouth to the outer mouth, cut the rectum and anal wall of all the fistulas along the direction of the probe, and open the entire length of the fistula.

4. All fistulas: Incisions are made on the skin on both sides of the open fistula, and the incision continues deeper along the incision. The incision is oblique to the deep layer of the fistula, and the whole fistula is removed. If there is a fistula branch, the tissue or scar stained with the methylene blue should be removed until the normal tissue is revealed. The wound is cut into a v-shaped cross section.

5. Stop bleeding: pressure to stop bleeding, ligation or suture to stop bleeding.

6. Repair the cutting edge: cut off the skin of the wound edge, trim it neatly, make the wound open, and put Vaseline gauze drainage.

complication

Difficulties in urination.

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