Dr. Ertan Beyatlı

Anal fistula stubborn goat

(Update: ) - Digestive System Diseases

What is an Anal Fistula?

Among the people, the words Anal "Fistula and Fissure" are often confused. However, both are completely separate diseases and there are completely different treatment methods. The word fistula is the connection point between two separate surfaces and means tunnel or channel.

Anal Fistula Anatomy Dr. Ertan BEYATLI 2020
Anal Fistula Anatomy Dr. Ertan BEYATLI 2020

It is a channel formed between the anus skin and intestines in anal or perianal fistulas.

The cause of the fistula is not known exactly, but many factors have been found to be effective in the formation of the fistula. Inflamed pimples in the seat area, chronic abscesses that occur frequently in the anus (Anal Abscess), radiotherapy, postoperative patients, overweight patients, .. etc.

Goodsall's Rule in Peri-anal Fistulas
Goodsall's Rule in Peri-anal Fistulas

Diagnosis / Diagnostic method

Examination by the surgeon is the best and accurate method of diagnosis. Sometimes, color / contrast x-rays can be taken to determine the degree and type of fistulas. (Fistulography). It is very important to make the correct diagnosis because hemorrhoids, anal fissure ve anal abscess Diagnosis causes the disease to continue and become chronic after surgery.

Anal Fistula - Park Classification
Anal Fistula - Park Classification

Park Classification

According to this classification, there are 5 types of Peri-anal Fistula:

a- Superficial
b- intersphincteric
c- transficteric
d- suprasphincteric
e- extrasphincteric

Is There a Treatment for Anal Fistula?

There are different treatment methods for fistula. Some surgeons prefer to tie a rope (seton) to the anus region, and some prefer surgery. Laser application is also a new method. The treatment option depends on the surgeon's opinion and the type and extent of the fistula.

In Peri-anal Fistula surgery, the patient is anesthetized from the waist (spinal, epidural) or completely anesthetized. In the gynecological position, the fistula canal and its length are determined by means of a probe or guide (stile). The fistula canal is completely removed with a cautery tool. The remaining tissues are left open or stitched.

seton for fistula existed at the time of Hippocrates

Seton application for fistula is a method remaining from the time of Hippocrates. It is still applied frequently even today.

In the Seton method, a rope is placed in the fistula canal. There are two types of setons. Loose and taut seton.

Loose seton keeps the canal open and clean. In the taut seton method, the rope is tied tightly or a weight is placed on the rope (such as key, lead, bead). In this way, over time, the rope starts to cut the canal there and causes the fistula to close. In this case, the breech muscles are not damaged (sphincter muscles). Imagine an ice cube cut with a wire.

In recent years, laser application has been applied for fistula. As with hemorrhoids, it is a short, risk-free and non-surgical method. For more information about laser Hemorrhoids treatment with laser You can look at my article.

https://www.youtube.com/watch?v=gANM5RLBZvU
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