Complex anal fistula resection

Complex anal fistula resection is an operation for anal fistula treatment. Precautions for complex anal fistula resection: 1. Violence should not be used during probe exploration to avoid false roads, mistakenly leave the inner mouth and the deepest fistula, resulting in recurrence of infection and re-formation of the fistula after surgery. 2. If the internal opening cannot be found, first open the section of fistula that the probe has touched, then look for the opening of the internal fistula at the site where the wound is stained with blue, and continue to insert the probe to explore. You can also squeeze the fistula with force, you can see a little pus or Meilan overflow from the mouth. You can also use a forceps to clamp the outer mouth of the fistula and its wall, pull and relax outwards, and a depression area is formed near the anal fistula of the bowel wall under the anus speculum, which is mostly where the inner mouth is. 3. When opening the fistula, if the anal sphincter is encountered, the direction of the incision must be perpendicular to the muscle fibers. It should not be cut obliquely or cut two places at the same time. 4. After cutting the anal fistula deep in the anus, it is not suitable for fistula resection, because the anal sphincter is relatively weak, and there is no support for the puborectalis muscle. It is not easy to align after resection, which may cause fecal incontinence. Once cut off, use a 2-0 bowel to loosen the 8-shaped suture to prevent retraction. 5. When removing the posterior complex anal fistula, be careful not to damage the coccyctalis, so as to avoid the anal canal to move forward. 6. For tuberculous fistula, the application of anti-tuberculosis drugs before surgery should be reasonable. If the contamination during operation is not obvious, the wound can be sutured with thin stainless steel wire or nylon thread after the fistula tuberculosis tissue is completely removed to eliminate the dead space.