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Has anyone had successful advancement flap fistula surgery?

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Crohn's Disease
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Posted 9/18/2018 7:23 PM (GMT 0)
Hey all,

Tomorrow my CRS is going to perform an endorectal flap operation on my perianal fistula. I’ve had this thing about a year now, and after a few i&d and a draining seton which came out by itself after two weeks, I eventually got a draining seton that stayed put. It’s been in now for about 2.5 months. I get a small amount of drainage a few hours after bowelmovement and discomfort, while there, is minimal. I do not have chrons.

My question is, has anyone had a successful flap operation? These forums are full of people who unfortunately have had failed surgery, many of whom have chrons or other health issues, but I suspect many who have successful surgery just don’t come back on here afterwards. The research I’ve read suggests success rates in non chrons patients is anywhere between 60-90%. My CRS said his success rate for the op is around 70-80%.

Any advice on recovery or your experience would be GREATLY appreciated. I have learned not to jump ahead too much with fistula, and it’s such a tough thing to get rid of, but I remain optimistic.
Posted 9/18/2018 10:48 PM (GMT 0)
I have had an advancement flap (and have Crohn's) and, it did not take for me. I had a rather large fistula that passed material regularly with BMs and previous setons and other procedures (in addition to going through a few different biologics and periodic courses of antibiotics, etc.).

Recovery for me was slow and I think the waiting after surgery is among the hardest parts (my understanding is that healing can take a wide range of times and some people heal secondarily). I had a painful build up of fluid, etc. not long after surgery (pain meds and sitz baths helped a bit). Stay patient and positive, but don't hesitate to reach out to your CRS with questions and concerns. You know your body best.

Since then, I had a temporary ileostomy (although 2+ years now) and went with a more aggressive approach using gracilis muscle. Good news is the repair with the muscle worked and is holding two years ago (although I developed another fistula shortly after...thanks, Crohn's). Hopefully given your non-Crohn's status the advancement flap will be successful and, if for some reason not, know that's not the end of the road if you don't want it to be!

Best of luck!
Posted 9/25/2018 7:33 PM (GMT 0)
I had major fistulas for about 2 years. I went through 10 surgeries trying to get the last one healed. I did have an advancement and it was successful!! I still have a small exterior opening, but beyond that it is healed and completely closed off!
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