complex anal fistula resection

1. Non-surgical treatment of low anal fistula that does not heal for 3 months. 2. Tuberculous anal fistula, no systemic active tuberculosis. Treating diseases: tuberculosis anal fistula Indication 1. Non-surgical treatment of low anal fistula that does not heal for 3 months. 2. Tuberculous anal fistula, no systemic active tuberculosis. Contraindications Older, combined with severe heart, liver, kidney and other diseases and difficult to tolerate surgery. Preoperative preparation 1. Patients with acute infection should control the symptoms, and take a bath with 1:5000 potassium permanganate warm water, until the acute inflammation subsides before surgery. 2. Tuberculous anal fistula, 2 weeks before surgery, anti-tuberculosis drugs were used. The patient had no symptoms of tuberculosis poisoning. 3. Enter the fluid diet 1 day before surgery. 4. Enema with soapy water 2 to 3 hours before surgery. Surgical procedure If there are more than one external or internal mouth, you can first insert gauze into the anal canal, and inject the blue from the earliest appearance in the medical history to observe the position of each internal mouth. Probes were used to probe the earliest fistula, cut and removed in a single piece, and then the outer or inner mouth of each branch was examined one by one, and all of them could be cut, but not necessarily all, resulting in postoperative scar stenosis. If some fistulas are located above the shallow group of the anal sphincter, or if there are multiple internal mouths, they should not be cut temporarily. First, use black thick thread to pass through these fistulas, loosening and knotting one by one for the mark, after the shallow wound is healed, After the operation, the deep fistula was opened one by one. This method can avoid the incontinence caused by cutting all the deep and shallow anal sphincters at the same time or cutting two or more anal sphincters at one time. complication Blood seepage, urinary retention