Rectal fistula operations - Ars Medica Laserclinic

70 % of the surgically operated abscess recovers without complications but in 30% of the opened abcess a canal remains between the wound and the cavity of the rectum. This is called fistula. In case of rectal fistula at stand steady defluxion discharge occurs at the external opening -round the anus- of fistula, making patients' lives tremendously uncomfortable by discolouring their underwear. Once a fistula is blocked, an inflammation evolves- onto what pain draws the attention -and another abscess may be formed. Types of rectal fistulas are defined by their connection to the anal/rectal muscular system.

Spontaneous recovery is impossible, so the only treatment for permanent rectal abscesses is surgical disclosure and incision, post-operative unclosed wound treatment until its fully healed.

During the examination that is carried out by a surgeon a blow-pipe is led into the external opening of the fistula and so is the internal opening is detected. Then comes the rectoscopy during such examination the lower app. a 15-18-cm-long part of the rectum is observed in order to eliminate other inflamed tumorous illnesses and so this means biopsy at the same time. If for pain the rectoscopy cannot be performed it is not forced but delayed after recovery. Afterwards the examining doctor gives detailed information for the patient on its state and recommended treatment. Considering the extremely painful inflamed area this operation is cannot be carried out in local anesthesia, only in general anesthesia. One-day-surgery is mentioned here as a special way of treatment together with all the required lab tests and other further exams to be carried out, the anesthesia types, possible complications, home care to-dos, phases of recovery, may occurring problems during recovery, so in a word all and every information that are necessary for the patient to make a decision on the way of treatment and/or surgery. The provided fully detailed oral information is certified by patients with their signature in their own information minute.

"One day surgery" means, that patients can leave the outpatient center on their own feet, accompanied by a helper, within 24 hours of surgery (usually after few hours of observation), and continue the healing process in the familiar confines of their own home. "One day surgery" requires strict professional, social, and various other preconditions that are discussed at the stage of the consultation when the need for surgery becomes clear. (I.e.: good general health, absence of serious systemic disease, patient must take responsibility for arrangement of transportation, home care, must have phone to contact the clinic or the surgeon if necessary, etc).

At the booked operative time patients must bring their lab tests, slippers, night-suit. Before placed into sick-room a "STATEMENT" is to be signed in order to entitle our clinic for the performance of the procedure. Besides patients have to undertake home wound care.

Considering that operation is performed in general anesthesia, food and drink intake is allowed until 24:00 pm on the prior day to procedure -for patient have to arrive with empty stomach for the surgery!

Please take the regularly taken drugs in time and dose. Take morning drugs with little liquid at home before departure and in case you may have drugs to be taken in day-time, please bring them with to the clinic!

The procedure is only performed in general anesthesia. In those cases when fistula is between compressor muscle of anus and wall of rectum the canal is independent from compressor muscle so disclosure and termination of fistula is freely performed. In case of highly reaching fistula two gum strings are led through the canal of the fistula, in order to keep the closing function of the anal muscle, and the first string is knotted under stretching. The dilated gum string slowly shrinks along days and so it cuts party the wall of fistula through ensuring enough time for compressor anal muscle to stick to the surroundings. After one week the second gum string is also knotted what cuts through entirely the wall of fistula. The so formed wound healed by secondary wound healing what leads to defluxion and takes app. 3-4 weeks. Unclosed wound treatment means regular bandage re-dressing and 'sitz' bath in camomile.

No doctor can guarantee that a complication-free surgery. Complications can arise even following the most carefully performed procedures. The post operative monitoring time spent at the clinic and the continuous connection keeping after leaving clinic serves the recognition of eventual early complications (e.g. post-bleeding, inflammation). Therefore if you recognise any little sign of emerge of complications (e.g. bleeding, fever), you may contact your surgeon 24/7 to solve your problem. Among late complications the damage of the anal muscular system is the most common causing dejecta continence difficulties. In order to prevent such the above-mentioned operative technique is performed that is tolerant with the compressor muscle by the protracted cut-through procedure. Complications can be prevented by careful post-operative observation and careful operation.

The post-operative observation time is usually 6-8 hour long, monitoring takes place until physiological functions (blood-pressure, urine) get stable again and patients can leave clinic on their own feet with accompany. In the first week of recovery physical load and -work must be avoided but permanent bed-rest is not necessary. The post-operative and string knotting pain can be well treated by drugs. Post-operative pain in the first 5-7 days may occur spontaneously but mostly at dejections. To terminate this use of painkillers tablets and rectal suppository work supplemented by intervallic chilling of the operative area and camomile bath. Settlement of dejection i.e. regular, soft dejecta during recovery is prominently important. Therefore intake of one spoon of liquid paraffin is proposed 3 times a day but usually no other ejective is necessary. Low-fever may occur on the first post-operative day. On the first post-operative days slight bleeding, later at dejections is not distressing. Defluxion of wound is normal for 3-4 weeks and use of panty-liners are recommended. The total recovery time takes app. four weeks and in this period of time physical load is to be avoided.

Fee of surgery: 0 HUF (paid by National Health Insurance Fund)
Charge for general anesthesia: 40.000 HUF (paid by patient, optional) > Euro
Charge for overnight stay: 0 HUF
Fees of control examinations: 0 HUF (paid by National Health Insurance Fund)

We provide air-conditioned, TV-, phone- and WIFI equipped one-or two-bedded rooms, personal nurse and meal but these mean no further costs for our patients.

Fee of surgery: 80.000 - 100.000 HUF > Euro
Charge for general anesthesia: 80.000 HUF > Euro
Charge for overnight stay: 30.000 HUF > Euro
Fees of control examinations: 5.000 HUF > Euro

50% of the fee is due at the time the operation is scheduled, as a prepayment.
These are estimated charges and may also be affected by the severity of the condition.

We provide air-conditioned, TV-, phone- and WIFI equipped one-or two-bedded rooms, personal nurse and meal.

INFORMATION ON RECTAL FISTULA