Rectal fistulas are preformed passages between the rectal cavity and the skin through which bacteria in the rectal cavity move with the soft tissue around the rectum, maintaining continuous inflammation, recurrent abscesses and secretions.
It is possible to eradicate the rectal fistula by first inserting a seton drain (a rubber tube), which allows the passage to be precisely separated from the fibres of the sphincter. Or if the fistula duct is seen to be independent of the sphincter during the preliminary examination.
There is little chance of spontaneous closure of the rectal fistula, so surgical intervention is needed to remove the fistula passage. If prior seton drainage has occurred, a scarred capsule has already formed around the main duct, which can be separated from its surroundings by eradication. In this way, the foreign body inside can be removed. And we can close the fistula.
Or, if the duct respects the ambulatory muscles, the fistula can be eradicated in one sitting.
After the operation, the complaints from the rectal fistula (recurrent abscess formation, secretions, inflammation) can be eliminated.
You will most likely arrive on the day of your operation, although it is rare that you will need to be in bed the night before. We will carry out the necessary investigations 1-2 weeks before the planned day of surgery, which may include laboratory tests, ECG, X-ray and anaesthesia if necessary.
The operation is performed under general anaesthesia, with the patient lying on a footrest. The skin or rectal orifice of the fistula is explored. Starting from the skin, the duct is excised along the seton drain, dissecting the sphincter fibres. Close the skin or rectal opening. The specimen is sent for histological processing.
In the case of surgical repair of rectal fistulas, the duct can be blocked with various tissue adhesives, plugs and Hippocratic knots. There are no conservative or drug therapy alternatives. If you have active Crohn’s disease, pre-treatment with medication is recommended.
Postoperative pain in the surgical area, skin and tissue damage, inflammation, scarring, wound infection, numbness around the wound, deep vein thrombosis.
During the operation, you will sleep and feel no pain. Upon waking, you can expect to experience some discomfort, and we will do our best to minimise this, or if it has developed, to alleviate it. There may be some discomfort in the surgical area, which should also improve considerably with the use of painkillers.
Painkillers will gradually become unnecessary over the coming period.
You can go home the next day after the operation.
After surgery, in addition to the recommended seated bathing, it is recommended to facilitate bowel movements by consuming 3×1 tablespoon of Paraffin oil daily.
When can I take a bath or shower?
There will be a clean covering dressing in the wound which should be changed daily. The day after the operation, the wound may already be in contact with water, and after bowel movements, the wound should be showered. After showering, the wound should be dressed with a covering dressing.
Exercise:
You will feel more fatigued in the few weeks after surgery, a gradual return to daily activity is recommended. For the first 2-3 weeks, avoid heavy physical work, lifting weights and intense sports activities.
Work:
Return to work depends on the type of work and the extent of the surgery. Expect to return to work within 1-2 weeks.
