Perianal fistula: surgical treatment

Written by: Dr. Javier De Oca Burguete
Edited by: Top Doctors®

After learning what it is and what symptoms a Perianal Fistula presents , the next step is to know how is the surgical treatment of this pathology.

The objective of the surgery of the perinanal fistula is the total healing of the fistula and the preservation of an adequate function of the sphincters that avoids the appearance of undesirable sequelae such as incontinence.

Treatment of a fistula

The treatment of perianal fistula is exclusively surgical and should always be entrusted to a specialist, given that the decisions made by the surgeon can have a huge impact on the future quality of life of the patient. The surgeon must have various therapeutic options to be able to approach each case in an individualized and duly consensual way with the patient. This may require the support of some complementary radiological examinations to help make the surgical decision.

During the last years perianal fistula surgery has been oriented towards increasingly less aggressive surgical procedures that avoid extensive injuries , many of them with long healing periods.. These techniques, in turn, are providing increasingly satisfactory results.


Very often, treatment of the fistula requires several interventions. In the first, we proceed to the placement of a rubber or silk tutor known internationally as seton , (seton) along the fistulous tract. This line is introduced along the entire fistula and emerges through the internal and external orifice of the fistula joining both ends out as a loop. This aims to consolidate the path of the fistula, prevent new infections and make it more affordable for the second surgery. This is done after two or three months, during which time the patient can live a normal life without any restrictions.

The technique of definitive surgery depends on the preferences and the experience of the surgeon with each of them. The use of biological substances to seal the path of the fistula, or the location and section of the fistula through a minimal surgical incision are some of the preferred techniques, which provide a percentage of healing greater than 75% .

After surgery

A perianal fistula operation does not prevent new fistulas from arising in the future. Undoubtedly, there is a percentage of recurrences. However, the modern non-aggressive techniques allow to face this situation with greater optimism than years ago. The main advantage of this operation is that after the surgery the patient is fully recovered and, after a reasonable period of rest and with simple cures, you can return to normal everyday life.

*Translated with Google translator. We apologize for any imperfection

By Dr. Javier De Oca Burguete
Colon & Rectal Surgery

With over 20 years of experience, this doctor is one of the leading specialists in colorectal and Proctological surgery. She currently chairs the Spanish Society of Surgical Research and has an important research career, during which he has published over 100 scientific articles and has directed eight doctoral theses.

*Translated with Google translator. We apologize for any imperfection

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