Perioperative management - Seton drainage in high transsphincteric anal fistula - general and visceral surgery
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Indications
- Intermediate transsphincteric fistulas
- High transsphincteric fistulas
- Suprasphincteric fistulas
- Acute abscess with existing fistula that initially cannot be laid open
Contraindications
- Patients who are inoperable
Note: Chronic inflammatory bowel disease is not a contraindication for this surgical technique.
Preoperative diagnostic work-up
- The necessary diagnostic work-up depends on the underlying problem and the urgency of the acute inflammation. As a rule, no specific examination modalities are required. Possibly helpful in special cases: Anal endosonography, CT or MRI
Special preparation
- None
Informed consent
General:
- Bleeding
- Thrombosis
- Embolism etc.
Specific:
- Persistent secretion
- Protracted healing
- Long healing period
- Renewed abscess formation
- Usually requiring further surgery
Anesthesia
Positioning
Operating room setup
Special instruments and fixation systems
Postoperative analgesia
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