Open Gastrointestinal Fistula Surgery in Chennai

Overview

A fistula is an abnormal connection between two body parts (an organ and a blood vessel). Gastrointestinal fistulas are abnormal openings (in the form of a tunnel) in the stomach or intestine that connects with other organs. The opening causes leakage of gastric or intestinal juices and content into other body parts.

These fistulas are often seen in people with infections or as a complication of surgical procedures (in people who have had abdominal surgery). If you suffer from chronic digestive tract conditions like Crohn’s Disease, you are at a high risk of developing gastrointestinal fistulas.

Depending on the location of the fistulas, you may suffer from diarrhea, malnutrition, and weight loss. Gastrointestinal fistulas close on their own after a few weeks to months. You may be given symptomatic treatment like immune suppressants and antibiotics. Surgery is recommended if no improvement is seen after 3 to 6 months of medical treatment.

What Is Open Gastrointestinal Fistula Surgery?

Open gastrointestinal fistula surgery is the surgical way of treating fistulas in the stomach and intestine. This method is the last resort when the fistulas are not healing even after 3 to 6 months of conventional treatment.

This surgery involves cutting open the fistula to drain the contents. The size of the incision taken depend on the size of the fistula. Once drained, the fistula is allowed to heal on its own. You may be prescribed antibiotics to treat the infection causing the pus. 

This surgery is performed as an outpatient procedure, and you may be allowed to go home the same day.  In some cases, a 2 to 5-day stay at the hospital may be advised by the surgeon. Recovery from open gastrointestinal fistula surgery is crucial, and you must follow the doctor’s instructions on diet and exercise.

How To Prepare For Open Gastrointestinal Fistula Surgery?

Open gastrointestinal surgery is the surgical way of treating a fistula that has not healed after 3 to 6 months of treatment. The surgery aims to cut open the fistula, drain the contents out, and perform repair work to ensure gastrointestinal tract continuity and optimal functioning. Here is how you can prepare yourself for this surgery-

• Your surgeon will discuss your medical history and perform a general physical examination. You should inform your surgeon about the medications you are taking, your dietary history, any allergies to medications, and any supplements you are taking presently.
• Your surgeon will advise certain tests before you go in for surgery. These include routine blood tests and imaging tests
• You will be asked to stop medications like blood thinners (to prevent excessive bleeding during and after surgery) a week before surgery.
• On the day of the surgery, you will be asked to fast for at least 12 hours before the surgery
• You will be asked to sign an informed consent form agreeing to proceed with the surgery.
• You will be asked to arrange for a friend or relative to drive you home after the surgery is completed.

How Is Open Gastrointestinal Fistula Surgery Performed?

Fistula surgery is advised when the fistula has not healed on its own, even after 3 to 6 months of treatment. The surgery is done under anesthesia and involves cutting open the fistula to drain the pus and blood filled inside. 

Special drains are attached to allow the fistula to heal while draining. The procedure is done by negative Pressure therapy, in which a vacuum increases blood flow and improves drainage. 

Depending upon the size and severity of the fistula and the adjacent structures involved, the surgeon will follow one of these steps-

• Your surgeon will cut off the fistula tract along with a small portion of the intestinal segment. Once the diseased tissue is removed and the pus is drained, the fistula becomes an open groove and left to heal on its own. 
• A fibrin glue or collagen plug will seal the fistula's internal end after draining it.
• Your surgeon will then apply a  fistula clip closure in which an implantable clip is used to close the internal opening. The constant pressure from the clip helps drain out the fistula, promoting its healing.
• If the infection and inflammation of the Gastrointestinal (GI)  tract due to the fistula are not extensive, then the surgeon will connect the two ends of the fistula. This procedure is called primary anastomosis and helps maintain the GI tract's continuity.
• If the inflammation and infection are severe, the surgeon will cut off the damaged part and consider leaving the ends of the fistula open for healing. The surgeon may create a surgical opening called a stoma that will help drain the contents through an alternative route while the operated area is left to heal. After 3 to 4 months, when the ends have healed, the ends of the fistula are surgically reconnected, and the stoma will close.

The surgery is done under local or general anesthesia You will be monitored for a few hours after surgery. Once you are stable, you will be sent home with instructions on wound care, diet, and exercise. You may sometimes be required to stay in the hospital as per your surgeon’s advice.

What to Expect After an Open Gastrointestinal Fistula Surgery?

The prognosis and outlook after an open gastrointestinal fistula surgery depend on the person’s health and how bad the fistula was. Recovery time is the most crucial part after this surgery. Remember that you will need to rest a lot while recovering. You will experience some pain and discomfort once the effects of the anesthesia start to wear off.

Make sure you follow all the instructions given to you on discharge. You will be given antibiotics to treat the infection if the pus has been drained. Pain medications will also be prescribed to help you manage the pain.

Here are some tips to help you heal faster:

• Avoid strenuous activities for 1-2 weeks after surgery. Take adequate rest. You may be able to get back to work the next day, but you will end up feeling exhausted very quickly. Hence it is advisable to take things slow.
• Keep the wound dry and change the dressing regularly.
• Keep up your nutrition levels. Preferably eat bland food for a couple of weeks. Avoid spicy, oily, and salty food
• Stay hydrated by drinking adequate amounts of water
• Avoid activities that strain the abdominal muscles, like pushing, pulling, and bending.

What Are The Benefits And Risks Of Open Gastrointestinal Fistula Surgery?

Fistulas can be a cumbersome condition to live with. They cause chronic malnutrition and weight loss. They can get infected and lead to a dangerous condition called sepsis. Surgical treatment is extremely beneficial in dealing with a fistula. A surgical repair ensures that the fistula does not come back. A fistula surgery, done by an experienced surgeon, has a success rate up to 97%, and the chances of recurrence are also very low.

As with all surgeries, an open gastrointestinal fistula surgery comes with its risks and benefits. There may be reactions to the anesthetic, like nausea, vomiting, and dizziness, as seen with all surgeries. Some specific risks associated with this surgery include-

• Infection
• Bowel obstruction
• Losing control of the bowels
• Recurrence of the fistula

Why Choose Medfin?

Surgery can be a daunting aspect, and feeling anxious is absolutely normal. The massive amount of information you can get from the internet may confuse you even more. This is where Medfin can help. Leave us the hefty task of finding the best hospital, the finest doctor, and the latest procedure at the lowest cost. Let us take charge while you sit back and focus on your health and recovery. Think surgery! Think Medfin!