Anal Fistula the management of convoluted anal fistula remains a test for specialists and a baffling issue for patients. Treatment expects to cure the condition, with seepage of the related contaminated organ abscess and annihilation of the fistula tract. The greater part of perianal diseases are either idiopathic or crypto-glandular in inception. All techniques for fistula repair depend on the disposal of the fistula interior opening to the anal gland. Anorectal abscess and the fistula that it may bring about, are long-term processes, initially portrayed toward the start of the recorded medical history, as a component of the ''Corpus Hippocraticum'' in a treatise termed ''On Fistulae''
The notable reasons for a typical/confused abscess and fistula, including inflammatory bowel disease, contagious disease, mycobacterial contamination, neoplasm and injury. Fistulas, auxiliary to these procedures are named complex and require the utilization of nonstandard systems for management. The most regular giving grumblings of patients a anal fistula are swelling, agony and release. The previous two manifestations are normally connected with a abscess, when the outside or optional opening has shut or has neglected to create Anal fistula may be mistaken for suppurative hidradenitis and pilonidal sinus and the specialist should be mindful so as to make the right determination.
Avoidance of contour defects, experiencing less pain due to the absence of a perineal wound and a faster healing process are the AMF (advancement mucosal flap) advantages. A few types of setons used are the Ayurveda-medicated thread, braided sutures, thread, rubber band, Penrose drains, and cable tie seton, Seton material should be non-absorbable, from non-slippage material, comfortable and least irritant for the patient and equally effective in causing focal reaction in the track, leading to fibrosis. Sphincter-sparing procedures are the standard treatment of anal fistula. The search for the effective treatments, not compromising continence has led to the development of the following techniques: 1) Anal fistula plug 2) Ligation of the intersphincteric fistula tract (LIFT) 3) Fibrin glue 4) VAAFT.
In a statistical study, subcutaneous fistula was diagnosed in 23.3%, inter-sphincteric in 18%, trans-sphincteric in 37.7%, supra-sphincteric in 16% and extra-sphincteric in 5% of patients. Single-tract fistulas were present in 88.7% and multi-tract fistulas were present in 11.3%. Overall, 242 patients had primary fistulas and 58 patients had recurrent fistulas. The most frequently performed procedures were cutting seton (139 patients) and radical fistulectomy (104 patients). Recurrent fistulas developed in 14.3%. Postoperative gas and/or stool incontinence was noticed in 10.7%. The recurrence rate was 5.4% in patients with primary fistula and in 51.7% patients presenting with a recurrent fistula. Gas and stool incontinence developed in 3.7% of patients with primary fistulas and in 39.7% of patients presenting with recurrent fistulas.