Anal Fistula An anal fistula is commonly known as Fistula-in-ano as it is frequently the result of a previous or current anal abscess. An anal abscess is an infected cavity filled with pus found near the anus or rectum. The fistula is the tunnel that structures under the skin and interfaces the stopped up infected organs to a abscess. A fistula can be available with or without an abscess and may join just to the skin of the buttocks near the anal opening. Microscopic organisms, fecal material or foreign matter can obstruct a butt-centric organ and passage into the tissue around the anul or rectum, where it might then gather in a cavity called an abscess.
Anorectal pain, swelling, perianal cellulitis (redness of the skin) and fever are the most common symptoms of an abscess. Occasionally, rectal bleeding or urinary symptoms, such as trouble initiating a urinary stream or painful urination, may be present. The surgery may be performed in the meantime as waste of a abscess, once in a while the fistula doesn't show up until weeks or years after the starting drainage. Fibrin glue injection is one such alternative, in which fibrin glue is infused into the fistula tract to decimate the tract with the expectation of getting to be joined in the encompassing tissue. An endoanal advancement flap is a strategy generally held for complex fistulas or for patients with an expanded potential danger for affliction incontinence from a conventional fistulotomy.
The database for the period 1995–2009 was searched. A systematic analysis was carried to evaluate the success rate of AFP procedure in fistula-in-ano. A total of 25 studies were extracted and 12 (n = 317) were finally included in the systematic review. The follow-up period ranged from 3.5 to 12 months. The AFP procedure had a success rate (patient cure rate) ranging from 24% to 92%. In complex fistula-in-ano in prospective studies (8/12 studies), the success rate was 35–87%. The success rate in patients with Crohn’s disease was 29–86%. The success rate in the patients with single tracts was 44–93% and in patients with multiple tracts, success ranged from 20% to 71%. The abscess formation/sepsis rate was 4–29% (11/108) and the plug extrusion rate was 4–41% (42/232–19%). Anal fistula plug procedure has a success rate ranging from 24% to 92% in different studies. In prospective studies of complex fistula-in-ano, there was a moderate success rate of 35–87%. As AFP is associated with low morbidity and sepsis, it appears to be a safe procedure.