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Anon asked...

Can a low fistula be operated on?

Tags: cancer

Is there any hope at all after three years of rectal cancer treatment that a low fistula can be operated on with hope of positive outcome because of radiation damage or is there any chance it might evetually heal if surgery isnt performed, lived with it for eight months. could scream.

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The answer

I’m sorry to hear that on top of the trauma of having radiotherapy for cancer, you’ve now developed a complication. A fistula is a channel between one hollow organ and another (such as between your bowel and your vagina) or one hollow organ and the skin. It’s a well-recognized complication of radiotherapy. Unfortunately, anal fistulae very rarely heal by themselves and it is likely that you will need surgery. This can be technically difficult, because the fistula often runs close to the ring of muscles around your anus that allow you to keep control of your bowels, and damage to this can lead to incontinence. The type of surgery will depend on a number of factors including where the fistula lies in relation to this ring of muscle. The most common kind involves cutting the fistula open along its whole length and flattening it out to heal as a flat scar. In complicated cases a flap of skin (taken from the skin around the anus) is attached to the internal opening of the fistula after the fistula has been cut open. Some trials of a glue made with fibrin (which helps blood clot) are going on. However, the long term success rate of this non-surgical method has not been very high in trials so far.

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