Treatment Approaches for the Effective Management of Anal Fistula in the Modern Era

Abstract

A complication of incision drainage or abscess ulceration around the anus and rectum is anal fistula which manifests as the creation of irregular channels linking the rectum and anal canal with the skin circumambient to the anus. It mostly affects the male population having a yearly frequency of two cases per ten thousand individuals. Histologically in anal fistula chronic inflammatory cells and fibrous tissues are surrounded by epithelialization of variable degree, which are categorized as squamous, columnar, or transitional zone epithelium. Anal fistula influences the psychological condition of the patients, which leads to depression or anxiety symptoms, in addition to severely impacting their standards of living. In general, anal fistula cannot be treated without medical intervention and the most efficient treatment for anal fistula is surgery. The optimal treatment in the modern era includes the elimination of the infected lesion, adequate drainage, and fistula closure while minimizing injury to the anal sphincter which includes treatment with fibrin glue, fistula plug, LIFT, etc.