Fistulectomy
Complete surgical excision of the entire anal fistula tract - providing a definitive tissue specimen for histological examination while eliminating the fistula. Appropriate for simple accessible fistulas at Lux Hospitals, Hyderabad.
What is Fistulectomy?
Fistulectomy involves the complete surgical excision of the entire fistula tract - including both internal and external openings and all intervening tissue. Unlike fistulotomy (which lays the tract open), fistulectomy physically removes the entire tract and sends it for histological examination. This is particularly important when tuberculosis, Crohn's disease, or malignancy is suspected as the underlying cause. Dr. Samhitha Reddy performs fistulectomy at Lux Hospitals, Hyderabad for simple and superficial fistulas where complete excision is feasible without significant sphincter sacrifice. As part of the comprehensive anal fistula treatment in Hyderabad programme, all specimens are examined by pathology - ensuring no underlying condition is missed.
How the Procedure Works
Pre-operative Assessment
Endoanal ultrasound maps the fistula tract and its relationship with the sphincter complex before surgery is planned.
Core Excision
Under anaesthesia, a probe is passed through the fistula. An elliptical excision removes both openings and the entire tract as a core cylinder of tissue.
Sphincter Assessment
The divided tissue is examined. Minimal additional division is made only if required for adequate excision while preserving continence.
Histopathology
The entire excised specimen is sent for histological examination - critical for identifying tuberculosis, Crohn's disease, or malignancy.
Wound Management
The excision wound is left open to heal by secondary intention. Daily dressings and sitz baths for 4–6 weeks. Regular follow-up with Dr. Samhitha.
Outcomes
Who Needs This Treatment?
- →Complete tract removal - eliminates all fistula epithelium that could lead to recurrence
- →Histological specimen available - essential for diagnosing TB, Crohn's, or malignancy
- →Higher confidence in complete excision compared to fistulotomy
- →Definitive single-stage procedure for simple low fistulas
- →Day-care procedure - no extended hospital admission
- →Effective for fistulas associated with prior abscess or recurrent infection
Fistulectomy is my preferred approach when we need both definitive treatment and tissue for pathology. Sending the entire tract for histology has on several occasions revealed an underlying diagnosis that changed the patient's long-term management.
— - Dr. Samhitha Reddy, Consultant Proctologist & Laparoscopic Surgeon
Common Questions
Frequently Asked
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