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

• Proximal transsphincteric anal fistulas

• Distal fistulas
• Rectovaginal fistulas

• Proctological examination: Inspection, palpation, proctoscopy, rectoscopy
• In addition: Fistula probing
• In special cases: anal endosonography, MRI

• In most cases oral antegrade intestinal lavage (generally recommended, although the level of evidence is not high)
• The fistula must be without acute inflammatory changes. This is usually achieved with a seton (e.g. Vessel-Loop®) in place for 8-12 weeks.

General:

• Bleeding
• Thrombosis
• Embolism etc.

Specific:

• Persistence of the fistula
• Recurrence
• Abscess