In recent times, the 25th batch of the Chinese Medical Team (CMT) in Sierra Leone carried out the first complex anal fistula surgery at the China-Sierra Leone Friendship Hospital, filling the gap in the field of anorectal surgery in the hospital and bringing good news for the health of local people.

Abdul is a Sierra Leonean male patient who has been suffering from perianal pain for a long time. Due to the lack of relevant surgical experience of local doctors, he has not received effective treatment. After careful examination, Xu Zhijie, a General surgeon, found that the patient had multiple fistulas, which was complex and difficult to treat. Undeterred by the difficulties, Xu Zhijie, along with the local surgical team, meticulously planned and executed a surgical strategy that combined incision with thread embedding (real and false thread embedding).

This innovative approach not only preserved the functional integrity of the anus while addressing the underlying issue but also significantly reduced the patient’s healing time and alleviate his pain. Despite operating with severely limited resources in the operating room, including equipment, instruments, and supplies, Xu Zhijie leveraged his extensive experience to adapt, using forceps as a makeshift probe and creating homemade multi-strand silk to replace rubber band thread embedding.

This resourcefulness was instrumental in the ultimate success of the surgery, which was performed in collaboration with the local surgical department director, Bah. After the operation, Xu Zhijie personally guided the local medical team in the management techniques of anorectal surgery, ensuring the smooth recovery of the patient. Xu Zhijie’s excellent medical skills and high-level clinical teaching ability were highly appreciated by both local doctors and patients.

51-year-old Xu Zhijie, as the eldest member of the medical team, is well-acquainted with the challenges of practicing medicine in challenging conditions. His unwavering patience and encouragement have inspired the local team to strive for the best health outcomes for patients amidst constraints