An Indian doctors, he pointed out has come up with a good technique for Fistulotomy
and repair of sphincter.
Fistulectomy was performed in patients in group A while fistulotomy
was done in patients in group B.
The mean age was 40.51 years (range: 21-72 years) in the fistulotomy
group and 41.14 years (range: 21-66 years) in the fistulectomy group (p=0.66).
Many surgical techniques have been described for the treatment of such anal fistula, including the use of seton, fibrin glue, collagen plugs, rectal advancement flaps, fistulotomy
with sphincter repair, and rerouting the fistula tract .
Data related to preoperative and intra-operative interventions along with postoperative outcome was collected for patients who were treated with either fistulectomy, fistulotomy
or seton placement.
There was no combination using a bio-flap, with the plug implantation in the external part of the tract and without partial fistulotomy
On the other hand the conventional Seton, Fistulotomy
and Fistulectomy can't be fully guaranteeing in the treatment of complex fistula in Ano.1
The scrotal opening of the fistula was laid open (fistulotomy
) over a malleable probe and curettage done for the remaining tract.
However, when planning treatment, each patient needs to be evaluated in detail, in order to avoid inappropriate treatment or overtreatment (i.e., a low, anovulvar fistula amenable with fistulotomy
is classified as "complex"), suggesting that also such classification has grey areas.
Biliary cannulation was successful in all patients with only one patient requiring precut fistulotomy
The surgical repair included a fistulotomy
with sharp dissection of the plane between the uterus, the bladder and the vagina.
The examination area should have available a range of proctoscopes, rigid sigmoidoscopes, haemorrhoidal banding, probes, local anaesthetic and instrumentation to allow excision of cutaneous pathology such as perianal haematomas, small skin tags, banding of haemorrhoids, simple haemorrhoidectomy, low fistulotomy
, sphincterotomy and excision of anal warts, abscess drainage, etc.