Perioperative management - Anal fistula, closure with Anal Fistula Plug® (AFP®)

• proximal, transsphincteric anal fistulas

• distal fistulas
• rectovaginal fistulas

• Proctological examination: inspection, palpation, proctoscopy, rectoscopy
• additionally: fistula probing
• in special cases: anal endosonography, MRI

• Usually, orthograde bowel lavage is required (generally recommended, but not supported by strong evidence).
• A fistula without acute inflammatory changes must be present. This is usually achieved by inserting a thread (e.g., Vessel-Loop®) for 8-12 weeks.

General:

• Bleeding
• Thrombosis
• Embolism etc.

Specific:

• Fistula persistence
• Recurrence
• Abscess