Which factors increase the risk of anal fistula recurrence?
An anal fistula is a condition of an infected tunnel that connects the cavity and abscess to the opening on the skin around the anal region. Usually, surgery is the mainstream treatment performed by the best fistula surgeon. However, the risk factors for the recurrence of anal fistula can be broadly segregated into the following categories:
- Risk factors associated with the presence of comorbidities and the fundamental anatomy of the fistula.
- Lack of appropriate pre-surgery assessment of fistula that fails to recognise the overall structure and the internal opening.
- Intraoperative loopholes involve inappropriate selection of treatment procedures and the inexperience of a fistula surgeon.
- Lack of appropriate post-surgery care.
Risk factors that enhance the risk of anal fistula recurrence
There are several factors involved in the risk of anal fistula recurrence, which are mentioned below:
Factors associated with the fistula anatomy and other comorbidities
According to the best fistula doctor in Kolkata, fistula can be classified into four groups that, include inter-sphincteric (Type I), trans-sphincter or type II, supra-sphincter or type III, and the extra-sphincter or type IV.
Out of the four groups mentioned above, the supra-sphincter type is one of the rarest forms of anal fistula. Such fistula continues to be in the same plane above the puborectalis muscle, moving downward between the levator and puborectalis to enter the ischiorectal fossa.
The high extension of anal fistula, with faulty treatment strategy and erroneous diagnosis, can also lead to fistula recurrence. Besides the anatomical factors, several other comorbidities enhance the risk of recurrence. Such factors include Crohn’s disease, diabetes, smoking, and immunosuppressed disease like HIV.
Preoperative factors which enhance the risk of anal fistula recurrence
The failure to identify the internal opening preoperatively can increase the risk of anal fistula recurrence. The internal opening determines the source point of the fistulous pathology. Hence, effective presurgery and intraoperative identification of the internal opening is extremely important for successful treatment and for reducing the risk of recurrence.
Intraoperative factors leading to anal fistula recurrence
Failing to complement clinical examination through proper imaging can enhance the risk of anal fistula recurrence. Even the best fistula surgeon finds it difficult to look for the internal opening in the absence of proper imaging.
The problem of anal fistula recurrence may also happen when a surgeon puts aside the basic principles of proctological surgery and attempts to emphasise the cosmetic effects. In order to avoid the risk of fistula recurrence, it is recommended to undergo surgery by the best fistula surgeon in Kolkata. This will also help you heal your anal fistula quickly and effectively.
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