OPERATION: Examination Under Anaesthesia, Abscess Drainage and Seton Insertion for Complex Anal Fistula
ANAESTHETIC: General / spinal anaesthesia
POSITION: Lithotomy
ANTIBIOTICS: Broad-spectrum IV antibiotics if sepsis present
INDICATION:
Complex anal fistula — [high trans-sphincteric / suprasphincteric / horseshoe component]. [Associated ischiorectal abscess]. [Crohn's disease / recurrent fistula]. MRI pelvis: [findings — track level, relation to sphincters, presence of secondary extensions]. Continence assessed preoperatively — patient counselled regarding seton placement and staged approach.
PROCEDURE: