Anal fistulas

Anal fistulas are connections between the rectal mucosa and the skin around the anus bypassing the anal canal. They are diagnosed and treated by ZweiChirurgen at our centre for proctology in Switzerland in Basel, Zurich and Liestal.

Anal fistulas usually develop following an acute perianal abscess. Through the internal opening of the fistula feculent fluid enters the fistula tract and appears at the perianal skin. Due to this permanent feculent contamination of the fistula the process is kept in chronic inflammation and can never heal. Therefore, an anal fistula can only be cured with surgery. The surgical therapy usually consists of two procedures. During the first operation the fistula tract is detected and secured with a comfort drain. This drain remains in the fistula tract for three months and prevents retention of feculent fluid and further inflammation of the fistula tract. After subsiding of the inflammation of the fistula tract the second operation aims to close the fistula. The applied surgical technique depends on the course of the fistula tract.

  • Sphincter-preserving Laser coagulation of the fistula tract (FiLaC)
  • Sphincter-preserving fistula plug
  • Closure of the fistula with a ligation (LIFT operation)
  • Closure of the fistula with mucosa advancement flap (so called Mucosaflap)
  • Surgical excision if the fistula tract (fistulectomy)
  • Lay-open fistulectomy
  • Closure of internal fistula orifice using clips (OVESCO clips)
  • Closure of the fistula tract using paste

Hospital stay: 2 days for complex cases (sphincter reconstruction, mucosa flaps)
Otherwise outpatient treatment in our practice OR

Anal fistulas graphical representation