Is anal fistula surgery complicated?

Whether anal fistula surgery is simple or complex depends on the specific condition of the fistula tract. Surgery for simple anal fistulas is relatively straightforward with low procedural difficulty, whereas surgery for complex anal fistulas—characterized by multiple tracts and intricate pathways—is more challenging and technically demanding. A detailed analysis is as follows:

A simple anal fistula has a straight tract without branches, with a clearly identifiable and superficial internal opening. The surgical procedure involves accurately locating the internal opening and then excising or incising the fistula tract. This process is relatively direct, causes minimal trauma, and allows for faster postoperative recovery. Most patients can largely recover within about one month after surgery.

Complex anal fistulas often involve multiple fistula tracts, side branches, or internal openings. Some tracts extend deeply into the pelvic cavity or wind around the anal sphincter muscles. During surgery, it is essential to completely remove the diseased tissue while preserving the function of the anal sphincter to prevent postoperative fecal incontinence. These procedures require high technical skill, meticulous operation, and generally take longer to perform.

Postoperatively, it is important to keep the wound clean. Patients should perform warm water sitz baths after bowel movements and change dressings as directed by their physician. In terms of diet, consuming high-protein and high-fiber foods is recommended to maintain smooth bowel movements and avoid constipation, which could irritate the surgical site. These care measures effectively reduce the risk of infection and promote wound healing.