| Overview An anal fistula is a chronic infected tunnel that runs from the anal canal to the skin near the anus. The anus is the external opening through which feces are expelled from the body. Just inside the anus are a number of small glands that make mucus. Occasionally, these glands get clogged and can become infected, leading to an abscess. About half of these abscesses may develop into a fistula. The signs and symptoms of an anal fistula include: Frequent anal abscesses Pain and swelling around the anus Bloody or foul-smelling drainage (pus) from an opening around the anus. The pain may decrease after the fistula drains. Irritation of the skin around the anus from drainage Pain with bowel movements Bleeding Fever, chills, and a general feeling of fatigue You should see your doctor if you notice any of these symptoms. |  |
Treatment for anal fistula with RFA technique
Radiofrequency in the treatment of anal fistulas: a (good) alternative to fistulotomy?
My personal results in recent years with the Fistura procedure:
60% prolonged closure (at least 12 months follow-up), on clinical assessment for crypto-glandular fistulas and on clinical and MRI assessment for Crohn’s disease related anal fistulas. It is therefore a procedure of choice among sphincter-sparing techniques but at the price of a precise selection of patients…
My indications?
Fistulas with a direct route, long (≥50 mm) and narrow (in practice, we just pass the 9 fr probe, i.e. about 3 mm) with an internal orifice that is not too wide, i.e. we can suture without too much tension without a connected diverticulum of more than 5 mm for Crohn’s fistulas.
Note that in case of Crohn’s disease, if the fistula is well dried out, and if all the clinical and MRI inflammatory signals are green, I don’t have the impression that the results are less good than for crypto-glandular fistulas. I therefore tend to propose RF before simple removal when the fistula has the above characteristics.
Dr. Dominique Bouchard, MD Procotologist, Head of the Proctology Unit, Maison de Santé Protestante Bagatelle, Talence, France
Marie Sautereau, Dominique Bouchard, Charlène Brochard, Fran?ois Pigot, Laurent Siproudhis, Jean Marie Fayette, Cécile Train, Anne Laurain, Charlotte Favreau, Laurent Abramowitz;
Colorectal Disease; September 21, 2022
