Conditions/Proctology
Anal Fistula
Seton, LIFT, flap, VAAFT, and sphincter preservation
Healing the track without destroying continence is the real goal.
An anal fistula is an abnormal track between the anal canal and the perianal skin, often after an abscess. Classification by sphincter involvement, Crohn’s disease, prior surgery, and secondary extensions shapes treatment. Simple distal fistulas may heal with fistulotomy; complex or high tracks need sphincter-sparing strategies such as seton, LIFT, advancement flap, plug, laser, or VAAFT. No single technique wins for every anatomy. Recurrence is real in complex disease — staged care and continence protection outrank speed of “one-shot cure” marketing.
Educational figures
Tap a figure to enlarge. These English illustrations mirror the Turkish hub gallery for this condition.
Tunnel concept Symptoms Seton LIFT
Continence first
Sphincter anatomy drives technique choice.
Seton role
Drainage and staged care in complex tracks.
Crohn’s context
Medical and surgical plans differ from cryptoglandular disease.
Recurrence reality
Complex fistulas may need staged treatment.
Key points for patients
- Abscess linkTap for details
Many fistulas begin as anorectal abscesses. Persistent discharge after drainage is a clue, not a minor nuisance.
- No single best operationTap for details · key note insideNoteThe wrong aggressive cut can trade a fistula for incontinence.
Simple distal fistulas differ from high transsphincteric or horseshoe disease. Technique catalogs are menus, not rankings.
- Imaging when complexTap for details
MRI helps map secondary tracks and sphincter involvement before committing to definitive surgery in complex cases.
- Crohn’s and medical therapyTap for details · key note inside
Inflammatory bowel disease fistulas need coordinated medical therapy; cutting strategies that ignore inflammation fail more often.
- Staged expectationsTap for details
Setons control sepsis first; definitive closure follows when sepsis and anatomy allow. Patience is part of continence-preserving care.
Patient journey
In this hub — follow the pathway step by step. Full Turkish illustrated pages remain linked from each chapter.
- 1
Anal Fistula Classification
Classification — explained for shared decision-making
Continue this step → - 2
Seton for Anal Fistula
Seton: what the procedure aims to do and who it fits
Continue this step → - 3
LIFT Procedure for Anal Fistula
LIFT: what the procedure aims to do and who it fits
Continue this step → - 4
Anal Fistula Technique Comparison
Comparison — explained for shared decision-making
Continue this step →
Appointment / info
Prior operative notes and MRI (if done) help planning more than a description of “another abscess.”
Educational information only; not a substitute for clinical evaluation.
Medical editor: Assoc. Prof. Cengiz Dibekoğlu, MD · English patient-education hub.