Fistulotomy vs Fistulectomy: What's the Difference?

Fistulotomy is a surgical procedure utilized to treat fistulas. This procedure can be used as an alternative to fistulectomy. Both offer distinct benefits and drawbacks. Understanding the differences is essential for patients looking to make an informed decision regarding their treatment. Continue reading, and we will discuss the difference and what you need be aware of in greater detail.

Why Do You Need Treatment for It & What is a Fistula?

A fistula is which is caused by the improper connection between two organs, or vessels. This can be found in several distinct locations, including:

• Urinary tract
• Aorta
• Vagina
• Skin
• Intestines
• Anus

A typical anal fistula can see the skin of the perianal (the skin surrounding the anus) developing to connect to the top of the canal. It can result in an anorectal fistula. This is connecting the anal canal as well as the surrounding opening. A rectovaginal fistula is an opening develop between the vagina and rectum.

This may hinder the functioning and movement of both organs, and therefore it is recommended to cut off the two organs and then remove the tissues.

Treatment Approaches

If a fistula is being treated, patients and physicians can decide between a fistulotomy, or fistulectomy.

Fistulotomy is typically an outpatient procedure. This means the procedure can be completed within a single day, and does not require a hospital stay. The procedure takes about an hour, however there is a interval between and after the procedure.

The method used obviously also depends on the severity of fistula. If the fistula is tiny and narrow, doctors may typically do the procedure in their office with local anesthesia. If the fistula is larger however, you may require general anesthetics that requires visiting the hospital.

In order to perform the fistulotomy surgery doctor or surgeon will cut a tiny incision to cut off an abnormal link between the two organs. The organs are able to move freely and function as they should and is a moderate procedure that's not terribly demanding on the patients. However, it does not actually take out any tissue this means it is likely that both "ends" will still be connected to the organs they belong to.

In a few rare instances it is possible that the Fistula doctor will have to cut a tiny amount of the sphincter muscles during the procedure. This could in certain instances result in incontinence. However, doctors will be very cautious to stay clear of this risk. 

Fistulectomy is a process which completely removes this tract. This can increase the risk of sphincter damage and, consequently, is not advised. However, it could be required if there's an excessive amount of tissue that is preventing normal function, or when there is a high chance of the occurrence of.

Other Procedures

For instance the seton method is the use of a small quantity of thread which is placed inside the fistula for a period of time. It keeps the fistula open and guarantees that, when healing takes place the fistula doesn't get closed once more. This also allows that the fistula drain. It is often able to cut out the need to cut the muscles of the sphincter.

In some instances there are instances when tight setons are required, and may need a series of smaller procedures.

Advancement flaps may be required when the fistula is passing through the muscles of the sphincter and is considered to be a risky procedure. The fistula can be scraped or cut out in the same way, and the slit that it has entered is covered with an area of tissue that is taken out of insides the rectum.

This may have a lower chance of success, but it reduces the chance of problems.

A LIFT procedure involves a tiny cut just above the fistula prior to separating from the sphincter muscle. The fistula then gets closed at both ends and it will be cut open until it's flat. This is not a new technique and more information needs to be taken. However, it's promising.

Endoscopic ablation employs a small tube equipped with a camera that can look at the fistula. An electrode is put through the endoscope in order to close the fistula. It has been proven to be efficient with a very low chance of complications.

Laser surgery involves a radiatal emission of lasers to close the fistula. Fibrin glue can be the sole non-surgical treatment option. It requires injecting the glue directly into the fistula when the patient is receiving general anesthesia. The glue will be able to seal the fistula in order to promote healing. It's less effective than fistulotomy, and it is only temporary. However, it is a good option to avoid surgery.

There are a variety of ways to treat this painful problem however, your Fistula surgeon in Kolkata should be able to guide you through the best treatment options for you.