Experts from the Nanjing Armed Police Hospital's Anorectal Center introduced that, taking the deep external sphincter muscle line as a mark, if the fistula passes above this line, it is considered high position; below this line is low position. A fistula with only a single internal opening, fistula, and external opening is called a simple anal fistula. Having two or more internal openings, fistulas, and external openings is referred to as a complex anal fistula. A low-positioned simple anal fistula refers to having only one fistula, one internal opening, and one external opening in a complete fistula.
The treatment principle for anal fistulas is to clear the internal opening of anal fissures causing bleeding [http://www.jswjyy.com/a/ganglie]. The same applies to low-positioned anal fistulas. Low-positioned anal fistulas can be treated through the following two surgical methods:
1. Surgical Treatment for Low-Positioned Anal Fistulas: Excision
The general method for treating low-positioned anal fistulas is excision. However, since the anus is a contaminated area with bacteria, if postoperative care is not handled well, complications such as wound infection can easily occur.
Low-positioned anal fistula excision surgery is suitable for all types of low-positioned anal fistulas, including low-positioned simple anal fistulas and low-positioned complex anal fistulas, as well as some high-positioned anal fistulas where part of the anal rectal ring has already fibrosed.
Surgical Method for Low-Positioned Anal Fistulas: One hand inserts a finger into the anus while the other hand holds a probe inserted from the external opening into the fistula. Gently probe along the direction of the fistula and carefully search for the internal opening, allowing the probe end to smoothly emerge from the internal opening. Follow the probe to cut open and extend the incision outward by about 1 cm [http://www.jswjyy.com/a/zhichuang/bingyin/]. Then trim the wound edges so that the incision becomes a relatively flat wound to facilitate drainage. The key to the success of this surgery, besides thoroughly opening the fistula, lies in accurately finding the internal opening. Most anal fistula internal openings are located within the anal sinus at the dentate line. Some are easy to find, with one end of the probe able to smoothly pass through the fistula and emerge from the internal opening, but in some cases, finding the true internal opening during surgery is not an easy task. Additionally, during digital examination, the internal opening often appears indented or has hard nodules. Carefully probing suspicious anal sinus openings with a hooked probe often deepens them, sometimes even up to 0.5 cm or more. In extremely rare cases, a rolled saline gauze pad can be placed inside the anus, then a 1% methylene blue solution can be injected from the external opening. If the gauze is stained, the internal opening will be in the corresponding location relative to the stained gauze.
2. HCPT Minimally Invasive Surgery for Low-Positioned Anal Fistulas
HCPT uses a rectal fiber scope to enter the anus. Through a monitor, direct minimally invasive electrocoagulation is applied to the internal opening, causing the anal fistula's internal opening to dry and close. Then, wash out the pus inside the fistula. After defecation, bacteria and fecal water from the stool cannot enter the surrounding tissue, thereby blocking the source of infection and pain, leading to recovery. It has functions such as high-frequency capacitive field hemorrhoid treatment, high-frequency electric knife, and capacitive field hemostatic clamp. The treatment process is painless, fast, thorough, does not require hospitalization, and does not affect work. The recurrence rate after treatment is extremely low. Experts from the Nanjing Armed Police Hospital point out that HPCT minimally invasive technology for treating high-positioned anal fistulas has four advantages:
1. Visual: Patients can watch their entire surgical process on a computer monitor; the entire surgical process is performed painlessly.
2. Efficient: The surgical process directly performs minimally invasive electrocoagulation on the anal fistula lesion without requiring any other operations.
3. Safe: The surgical process effectively blocks bacteria and fecal water from entering the source of infection until complete recovery.
4. Peace of Mind: Quick recovery after surgery without affecting normal work and study.
Experts from the Nanjing Armed Police Hospital's Anorectal Center pointed out that for the treatment of low-positioned anal fistulas, many patients avoid surgery due to fear of pain or侥幸 mentality regarding their condition, often choosing conservative drug treatments. This approach, however, can lead to worsening conditions and more leaks. What was initially one fistula opening can become two, three, or even more openings. Fundamentally speaking, the progression of low-positioned anal fistulas follows an "inside-out" trend, with the lesions located near the anal canal and rectum. Conservative treatment can only act on the skin around the anus, failing to reach deeper lesions.
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[Nanjing Armed Police Hospital Anorectal Center] http://www.jsgcw.com[http://www.jsgcw.com/]
[Nanjing Armed Police Hospital Anorectal Center] http://www.njgcyy.net[http://www.njgcyy.net/]
[Nanjing Armed Police Hospital Anorectal Center] http://www.jswjyy.com[http://www.jswjyy.com/]
[Nanjing Armed Police Hospital Anorectal Center] http://www.wjgc.net[http://www.wjgc.net/]
Consultation Phone: 025-85500079 Consultation QQ: 997287111
Hospital Address: No. 256 Heyan Road, Nanjing (100 meters to the right of the north gate of Hongshan Zoo)
Transportation Route: Get off at Hongshan Zoo Station on Subway Line 1; Take buses 30, 8, 64, 54, 72, 77, Yu Ge Line, Nan Zhou Line and get off at Dongjing Pavilion Station.
[Yangzhou Armed Police Hospital Anorectal Center] http://www.yzwjyy.com[http://www.yzwjyy.com/]
Consultation Phone: 0514-87218120 Consultation QQ: 997287111
Hospital Address: No. 8 Jiangdu South Road, Yangzhou City, Jiangsu Province
Transportation Route: Take bus lines 4, 19, 25, 26, 26 Late Night, 66, 66 Late Night, 101, 102, 201, 208, 209 in Yangzhou City and get off at the Armed Police Hospital station.
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