Fistulectomy is a surgical procedure where a fistulous tract is excised (cut out) completely. This procedure is done to remove a perianal fistula that can form after someone develops a perianal abscess. The fistula may form 4-6 weeks or even a year after the initial abscess, and about 50 percent of abscesses will develop a fistula.
To treat your fistula, our team of trained colorectal surgeons can provide you with surgical and/or non-surgical options that are best for you. By scheduling an appointment at the Fissure & Fistula Center of Excellence, and through individualized care and exams, a course of treatment can be tailor made to meet your medical needs.
A fistulectomy is performed on an outpatient basis using a general anesthetic or a spinal. The surgery takes approximately 45-60 minutes. There are 3 important parts of a fistula to identify prior to or at the beginning of the surgery.
- The external opening, which is usually obvious around the anal opening on the outside.
- The tract, which is the connection between the external and the internal openings.
- The internal opening, which is not always evident until during the surgery. Sometimes a blue dye is injected into the external opening to allow identification of the internal opening at the time of surgery.
The fistulectomy consists of removing or opening the 3 components, which is done by dividing the least amount of sphincter muscle as possible. The location of the internal opening will usually dictate how much of the sphincter muscle will be cut or divided. The further up inside the anal canal or rectum the internal opening is located, the more muscle will have to be incised or cut through, leading to more of a risk of leakage or drainage after the wound has healed.
Once the fistula has been removed, the groove or wound is left open to heal. Some fistulas can be very complicated and may require more than 1 surgery.
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The healing process usually takes 4-6 weeks. Pain medication and antibiotics will be given at discharge. There will be several post-op office visits required. Our La Peer doctors use minimally invasive techniques that promote quicker healing and less pain. We welcome you to call our surgical center to learn what options are available to you.
Q: What is the difference between a fistulotomy and fistulectomy?
A: A fistulectomy is where the fistulous tract is cut out completely. On the other hand, a fistulotomy is when the fistulous tract is merely laid open to heal.
Q: What can I do to promote successful healing?
A: Get plenty of rest, remove/change your gauze or pad frequently, take sitz baths 3 times a day and after bowel movements, and follow your aftercare instructions given by our La Peer doctors.
Q: Will I need to eat a special diet after surgery?
A: Immediately following surgery you may be advised to intake clear liquids only for 24 hours to minimize nausea and constipation (i.e. soup, Jell-O, juices, carbonated beverages, popsicles, and water). You will then be able to progress to a regular diet. Eating lots of whole grains, green leafy vegetables, and fruits are recommended.
Q: If I am having symptoms post-operatively, when should I seek medical attention?
A: Call our Los Angeles office if you are experiencing:
- Fever over 101 degrees F
- Pain not relieved by pain meds prescribed
- Blood with bowel movements that is more than occasional spotting
- Inability to urinate
- Persistent nausea or vomiting.
Q: When can I return to my normal activities?
A: You should rest for the first 24 hours and on average most patients can slowly resume normal activities. However, your physician will give you personal instructions on when you can return to your daily activities.
Meet with an Anal Fistula Specialist
If you suffer from fistulas and would like to learn more about your surgical options, contact our colorectal specialists today at (888) 512-2312 to schedule your consultation and get the help that you need.
For additional information, please read this article comparing fistulectomy and fistulotomy on the US National Library of Medicine.
Next, read about the LIFT procedure for anal fistulas.