Our Summary

This research focused on a new way of treating complicated cases of anal fistula, a painful condition where an abnormal connection forms between the rectum and the skin near the anus. The traditional approach to treating this condition often involves surgery that can potentially damage the sphincter muscle - a critical muscle for controlling bowel movements. However, this study tested a new technique which combines two existing procedures and uses a video to guide the surgery.

The research involved 103 patients and was conducted in a large hospital in Thailand from 2014 to 2017. It found that the new technique had an overall success rate of 84.5%, which is significantly higher than the 63.4% success rate of the traditional surgery. This success rate was judged based on whether the fistula healed completely, and whether there was any drainage from the wound. The patients also did not report any worsening of their ability to control their bowel movements after the surgery.

The researchers concluded that the new technique could be a promising treatment option for complex anal fistula cases, as it can preserve the sphincter muscle while still effectively treating the condition. However, they also noted that the sample size of the study was small, and that more research needs to be done to confirm these results.

FAQs

  1. What is the new technique for treating anal fistula that was tested in this study?
  2. How does the success rate of the new technique compare to traditional surgery?
  3. What are the researchers’ conclusions about the new technique and its potential for treating complex anal fistula cases?

Doctor’s Tip

A helpful tip a doctor might tell a patient about anal fistula surgery using this new technique is to discuss the option with their healthcare provider and inquire about the possibility of using this approach if they have a complicated case of anal fistula. It is important to weigh the potential benefits of preserving the sphincter muscle against the risks and benefits of traditional surgery. Patients should also be aware that more research is needed to further validate the effectiveness of this new technique.

Suitable For

Patients who are typically recommended for anal fistula surgery include those with complex or complicated cases of anal fistula, where traditional treatments have not been successful or have a high risk of damaging the sphincter muscle. These patients may experience symptoms such as recurrent anal abscesses, chronic pain, persistent drainage, or difficulty controlling bowel movements. Additionally, patients who have a high risk of developing complications from anal fistula, such as infection or sepsis, may also be recommended for surgery. It is important for patients to consult with a healthcare provider to determine the most appropriate treatment option for their specific condition.

Timeline

Before anal fistula surgery:

  • Patient experiences symptoms such as pain, swelling, and drainage near the anus
  • Patient may undergo imaging tests to diagnose the fistula and determine the best course of treatment
  • Patient may try conservative treatments such as antibiotics or sitz baths to manage symptoms

After anal fistula surgery:

  • Patient undergoes the new technique combining two procedures with the guidance of a video
  • Surgery is successful in 84.5% of cases, with the fistula healing completely and no drainage from the wound
  • Patients do not report any worsening of their ability to control bowel movements after the surgery
  • Researchers conclude that the new technique is a promising treatment option for complex anal fistula cases, as it preserves the sphincter muscle while effectively treating the condition
  • More research is needed to confirm the results and further validate the effectiveness of the new technique

What to Ask Your Doctor

  1. What is the success rate of this new technique compared to traditional surgery for treating anal fistula?

  2. What are the potential risks and complications associated with this new technique?

  3. How long is the recovery time after undergoing this new procedure?

  4. Will I experience any changes in bowel movements or continence after the surgery?

  5. How experienced are you in performing this new technique, and how many procedures have you performed using this method?

  6. Are there any specific lifestyle changes or post-operative care instructions I should follow after the surgery?

  7. Will I need any follow-up appointments or additional treatments after the surgery?

  8. How long will it take for me to see improvement in my symptoms after undergoing this new technique?

  9. What other treatment options are available for anal fistula, and why do you recommend this new technique for my specific case?

  10. Can you provide me with any additional information or resources to help me better understand the procedure and its potential outcomes?

Reference

Authors: Wanitsuwan W, Junmitsakul K, Jearanai S, Lohsiriwat V. Journal: Dis Colon Rectum. 2020 Nov;63(11):1534-1540. doi: 10.1097/DCR.0000000000001691. PMID: 33044294