Our Summary

This research study aims to create a system that can predict the risk of recurrence and complications after surgery for anal fistula, a painful condition where an abnormal connection forms between the skin near the anus and the rectum. The study will gather information from patients through a questionnaire system on WeChat, as well as from clinical, laboratory, and imaging data collected before, during, and after surgery. The results will be used to develop models that can predict the likelihood of complications such as wound bleeding, fecal impaction, urinary retention, delayed wound healing, and unplanned hospitalization. The goal is to provide patients and doctors with tools that can help prevent complications and identify high-risk patients earlier. The study has been approved by the ethics board of Shuguang Hospital in Shanghai, China, and the results will be submitted to international scientific journals or conferences related to colorectal surgery.

FAQs

  1. What is the aim of this research study on anal fistula surgery?
  2. How will the study collect information from patients and what kind of data will be gathered?
  3. What are the potential complications this study seeks to predict and prevent?

Doctor’s Tip

One helpful tip a doctor might tell a patient about anal fistula surgery is to follow post-operative care instructions closely. This may include keeping the area clean and dry, taking prescribed medications as directed, avoiding strenuous activities, and attending follow-up appointments with your healthcare provider. By following these instructions, patients can help promote healing and reduce the risk of complications.

Suitable For

Patients who are typically recommended anal fistula surgery include those who have recurrent anal fistulas that do not respond well to conservative treatments such as antibiotics or drainage procedures. Other indications for surgery may include:

  • Patients with complex or multiple fistulas
  • Patients with symptoms such as pain, swelling, discharge, and fecal incontinence
  • Patients with underlying conditions such as Crohn’s disease or immunosuppression
  • Patients with abscess formation or fistula-related complications such as infection or sepsis

Ultimately, the decision to recommend surgery for anal fistula will depend on the individual patient’s symptoms, medical history, and the severity of their condition. It is important for patients to consult with a colorectal surgeon or specialist to determine the most appropriate treatment plan for their specific situation.

Timeline

Before anal fistula surgery:

  • Patients experience symptoms such as pain, swelling, discharge, and itching around the anus.
  • They undergo a physical examination, including a digital rectal exam, to diagnose the anal fistula.
  • Imaging tests such as an MRI or ultrasound may be performed to determine the extent and location of the fistula.
  • Patients may be prescribed antibiotics or other medications to manage symptoms before surgery.

After anal fistula surgery:

  • Patients will have a period of recovery, which may include pain, swelling, and discharge from the surgical site.
  • They will need to follow post-operative care instructions, such as keeping the surgical site clean and avoiding strenuous activities.
  • Follow-up appointments will be scheduled to monitor healing and address any complications that may arise.
  • Patients may experience recurrence of the fistula, which can occur in a small percentage of cases.
  • Long-term complications such as incontinence or chronic pain may also develop, although these are rare.

Overall, the timeline for a patient experiencing anal fistula surgery involves pre-operative evaluation, surgery, post-operative recovery, and long-term follow-up to monitor for complications or recurrence.

What to Ask Your Doctor

Some questions a patient should ask their doctor about anal fistula surgery include:

  1. What is the success rate of anal fistula surgery?
  2. What are the potential complications of the surgery?
  3. How long is the recovery time after surgery?
  4. Will I need to modify my diet or lifestyle after surgery?
  5. How can I prevent a recurrence of the anal fistula after surgery?
  6. What are the signs of infection or other complications that I should watch for after surgery?
  7. Will I need to have a follow-up appointment after the surgery?
  8. What is the expected outcome of the surgery in terms of pain relief and quality of life?
  9. Are there any alternative treatments to surgery for anal fistula?
  10. How experienced is the surgical team in performing anal fistula surgeries?

Reference

Authors: Mei Z, Li Y, Zhang Z, Zhou H, Liu S, Han Y, Du P, Qin X, Shao Z, Ge M, Wang Q, Yang W. Journal: BMJ Open. 2020 Mar 4;10(3):e035134. doi: 10.1136/bmjopen-2019-035134. PMID: 32139494