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Dr. S. D. Chivate . . . Welcome . . .

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Do's & Dont's

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Fistula


D & C  for Simple fistula

  1. Search for internal opening
  2. Fistula guide ->
  3. Hegar ’s dilators
  4. Curette  tract & internal opening.
  5. Wash tract with Betadine & H2 O2
  6. Lift internal opening on big dilator Suture.
  7. Pack tract for 48 hours
  8. Syringe every day.

PROCEDURE

  1. Catheterization of fistula
  2. Location of internal opening
  3. Probe / guide wire in fistula
  4. Dilatation of fistula
  5. Curetting  of fistula track
  6. Washing of track
  7. Fistuloscopy for complex fistula
  8. Excision & suturing of internal opening
  9. Packing of fistula

RESULTS

  1. Operation opening is 1 Cm.
  2. Liquid diet for 3 days      if     int. opening Present
  3. Requires Daily H2O2 & BETADINE Syringing
  4. No packing every day.
  5. Wound heals in 8 to10 days
  6. Minimum scaring
  7. Minimum pain
  8. Can be repeated
  9. Histology Examination is possible.

MIS                                       RESULTS
SIMPLE FISTULA                    32 CASES
HEALED                                30 CASES
COMPLEX FISTULA                 16 CASES
HEALED                                14 CASES
FALLOW UP                       2 -- 36 MONTHS
PATENT                               FRIENDLY

There are encouraging technological advances (glues, plugs, stem cells & minimal invasive procedures ) that might have a place in treating a select number complex anal fistula.