What is the principle of surgical treatment of anal fistula?

Anal fistula refers to an infectious duct connecting the anus and rectum with the skin around the anus, also known as "anal fistula". Its inner mouth is often located near the tooth line, and its outer mouth is located on the perianal skin, and the fistula has not healed for many years. According to its main symptoms, people constantly ooze pus and blood from the sores on the skin around the anus, just like a broken house often leaks water. Our ancestors named this disease fistula. Fistula is that there are two pipes connecting sores inside and outside the human body, which can leak secretions and pus from the inside to the outside. Serious anal fistula, feces can flow out, just like a rat stealing feces hiding in a sore hole, which harms people from time to time, so it is also called "the rat stealing feces" figuratively.

① Incision and excision of anal fistula: The purpose of the operation is to cut or remove the internal orifice, fistula orifice, external orifice, branch pipe and scar tissue of anal fistula.

② Cut off the anorectal ring and sphincter: This operation can cause anal incontinence. Therefore, we should pay attention to the following two points:

First, it must be cut at right angles to the sphincter fiber direction;

Second, you can't cut off two places at a time. If you need to cut, you should operate in stages, or cut one line at a time.

③ One-stage skin grafting on the wound: cut off the fistula and the internal opening, stop bleeding and bandage, then rinse the wound with warm saline, cover the wound with thin skin flap, intermittently suture, and pressure bandage to control stool excretion.

④ Thread-hanging therapy: put the rubber ring into the fistula from the external mouth and out from the internal mouth, and tighten it to make the fistula wall necrotic and become an open wound, so as to achieve the purpose of healing.

⑤ Medicated twist therapy: Medicated twist is made of Chinese medicine with the functions of clearing away heat and toxic materials, removing putrefaction and promoting granulation, and inserted from the external opening of the fistula to heal the fistula.

⑥ Palliative resection: This operation does not cut off the external sphincter, and is suitable for low muscle fistula and posterior superficial anal fistula.