Our Summary

This research paper looks at how often people have to have repeat surgeries for a medical condition called anal fistula within England and Wales’ National Health Service. The researchers analyzed data from over 36,000 patients who had surgery for anal fistula between 2010 and 2016. They found that the majority (67.4%) only needed one operation. However, they also found that younger patients and female patients were more likely to need repeat operations. Those of non-declared and Black or Black British ethnicity had fewer surgeries. The average waiting time between surgeries was quite long - about 27 weeks. Patients tended to stay under the care of the same doctor, even if they needed multiple surgeries. The research also found differences in the number of surgeries and waiting times depending on where the patients lived.

FAQs

  1. What percentage of patients needed only one surgery for anal fistula according to the research?
  2. Who were found to be more likely to need repeat operations for anal fistula?
  3. What was the average waiting time between surgeries for anal fistula according to the study?

Doctor’s Tip

A helpful tip a doctor might tell a patient about anal fistula surgery is to follow post-operative care instructions closely to promote healing and reduce the risk of complications. This may include keeping the area clean, taking prescribed medications as directed, avoiding strenuous activities, and attending follow-up appointments with your healthcare provider. Additionally, maintaining a healthy diet and lifestyle can also aid in the recovery process. If you experience any unusual symptoms or concerns after surgery, be sure to contact your doctor promptly for further evaluation and guidance.

Suitable For

Overall, patients with anal fistula who are younger, female, and from certain ethnic backgrounds may be more likely to require repeat surgeries. It is important for healthcare providers to consider these factors when recommending surgical treatment for anal fistula. Additionally, patients should be aware of the potential need for multiple surgeries and the associated waiting times.

Timeline

Before anal fistula surgery:

  1. Patient experiences symptoms such as pain, swelling, discharge, and difficulty sitting or passing stools.
  2. Patient visits a doctor who diagnoses the anal fistula and recommends surgery as the treatment option.
  3. Patient undergoes pre-operative tests and consultations to prepare for the surgery.

After anal fistula surgery:

  1. Patient undergoes the surgery to remove the anal fistula and repair the affected area.
  2. Patient may experience pain and discomfort post-surgery and will be prescribed pain medication.
  3. Patient is advised on post-operative care, including wound care, diet, and activity restrictions.
  4. Patient attends follow-up appointments to monitor the healing process and address any complications.
  5. Patient gradually resumes normal activities and experiences relief from the symptoms of the anal fistula.

What to Ask Your Doctor

  1. What are the risks and potential complications associated with anal fistula surgery?
  2. What type of surgery will be performed for my anal fistula and why?
  3. How long is the recovery period after anal fistula surgery?
  4. Will I need to make any lifestyle changes or follow a specific diet after surgery?
  5. How likely is it that I will need additional surgeries in the future?
  6. What can I do to prevent the recurrence of anal fistulas after surgery?
  7. What are the success rates of anal fistula surgery in terms of complete healing?
  8. How long will I need to stay in the hospital after surgery?
  9. Will I need any special care or follow-up appointments after surgery?
  10. Are there any alternative treatments or procedures that I should consider before deciding on surgery?

Reference

Authors: Morales-Cruz M, Ali M, Christou C, Crothers H, McNulty D, Ward ST. Journal: Int J Colorectal Dis. 2023 Jun 22;38(1):174. doi: 10.1007/s00384-023-04467-w. PMID: 37349532