Surgical treatment for anal fistula by onetwo3


									                                                                               Surgical treatment for
                                                                                           anal fistula
                  1. Identification and description of the procedure

                  The perianal fistula is the communication between the anal canal and the perineal skin.
                  There are several procedures for treating this pathology: resection and flattening of the fistula (fistulotomy),
                  removal of the fistula path (fistulectomy) or fitting a ligature across the path for deferred seal (sedal).
                  It may be necessary to perform repair work for the sphincters or insert grafts, and in complex fistulas
                  connected with other organs, both holes shall be repaired and exceptionally it is necessary to use an
                  artificial anus.
                  There is a possibility that during surgery modifications might have to be made to the procedure as a result
                  of intraoperatory findings so as to provide the most suitable treatment.
                  The operation requires the administration of anaesthesia and it is possible that during or after the operation
                  it may be necessary to use blood and/or blood products, you will be informed about their risks by the
                  Anaesthesia and Haematology Departments.

                  2. Purpose of the procedure and benefits that are expected to be achieved

                  The surgical procedure that is going to be performed is meant to eliminate the fistula and correct the
                  possible anatomical alterations that it might have been able to cause.
                  By means of this surgical procedure, it is expected that the fistula will be removed for good, with the
                  subsequent disappearance of the painful discomforts, suppuration, inflammation and infection that it
                  involves, as well as the contamination of the perianal tissues in which abscesses are produced.

                  3. Reasonable alternatives to this procedure

                  There is no effective alternative for treatment.

                  4. Foreseeable consequences of its performance

                  Following the surgical operation, the fistula trajectory will disappear, and after a brief period of time
                  during which the surgical would will heal, it is to be expected that the fistula will be completely eliminated
                  and therefore there will be a complete cure for it.

                  5. Foreseeable consequences of its non performance

                  Should you not have the surgical operation, the fistula will persist, with chronic suppuration and acute
                  inflammatory episodes and the spread of abscesses. The fistula may become more complicated, with several
                  trajectories and holes, as well as larger areas and more distal from the perianal tissue and be the source
                  of serious infections of the perineum.

                  6. Frequent risks

                  Despite the appropriate choice of technique and its proper performance, undesirable effects may arise,
                  both the common ones deriving from any operation and that might affect any organ or system as well
                  as other specific ones from the procedure:

                        Bleeding and infection of the surgical wound, phlebitis, acute urine retention, inflammation
                        of the anus, prolonged pain in the area of the operation.

                  7. Infrequent risks

                  The following infrequent, though serious risks might arise:

                        Serious infection of the anus and perineum, incontinence of gases and even for faeces, anal
                        stenosis, reproduction of the fistula or hospital infection.

                  These complications are usually resolved with medical treatment (medicines, serums, etc…) but they might
                  require another operation, generally an emergency one, including a minimum risk of mortality.
                                                                                       Surgical treatment for
                                                                                                   anal fistula
8. Risks depending on the patient's personal and clinical situation

As regards the patient, he/she must report his/her possible allergies to medicines, problems with coagulation,
cardiopulmonary and renal diseases, existence of prosthesis, pacemakers, current medicines or any other
relevant circumstance that might complicate the operation or aggravate postoperative recovery.
Associated pathologies for each patient (diabetes, obesity, immunodepression, hypertension, anaemia, old
age...) might increase the frequency or the seriousness of risks or complications, hence, in these cases,
the general surgical risk is greater.

    9. Declaration of consent

    Mr./Mrs./Miss.                                 aged          , with home address at
                                                    , National Identity No.                          and SIP number

    Mr./Mrs./Miss.                                 aged           , with home address at
                                     acting in the capacity of (the patient's legal representative, relative or close
    friend)                                                       , with National Identity No.


    That the Doctor                                        has explained to me that it is advisable/necessary in my
    situation to perform

    In                          on                               ,2

    Signed: Mr./Mrs./Miss.                               With National Identity Card No

    Signed: Dr.                                         With National Identity Card No

    Associate number

    10. Revocation of the consent

    I hereby revoke the consent granted on the date of                            ,2               and I do not wish
    to carry on with the treatment that I hereby terminate on this date.

    In                          on                               ,2

    Signed: The Doctor                                  Signed: The patient
                                                                                                                        GENERAL SURGERY
                                                                                                                        SPECIALITY IN

    Associate number:

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