Fistulotomy in the Tertiary Setting can Achieve High Rates of Fistula Cure with an Acceptable Risk of Deterioration in Continence

Tozer, Phil; Sala, S.; Cianci, Valentina; Kalmár, Katalin; Atkin, Gary; Rahbour, Goher; Ranchod, Pravin; Hart, Ailsa; Phillips, R. K. S.

doi:10.1007/s11605-013-2198-1

Cited by 52 publications

(32 citation statements)

References 16 publications

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“…The healing rate of this technique ranges from 93%-100%. Because the sphincters are inevitably transected in this procedure, minor incontinence is reported in 11.5%-20% of cases [6][7][8][9]. For complex fistulas, however, treatment is more difficult and carries a higher recurrence rate and greater potential of external sphincter damage [10].…”

Section: Discussionmentioning

confidence: 99%

Initial Experience With Video-Assisted Anal Fistula Treatment in the Philippines

2020

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Purpose: We determined the outcomes of patients undergoing video-assisted anal fistula treatment (VAAFT) for fistulain-ano at the Philippine General Hospital.Methods: Twenty consecutive adult patients who underwent the VAAFT procedure from 2016–2018 were included in this investigation. Information detailing baseline demographic and clinical data, fistula type and classification, and previous surgeries were retrieved from in-hospital and operative records. Operative time, identification of the internal opening, method of internal opening closure, and occurrence of immediate postoperative complications were determined. The status of the fistula was assessed at one month, 3 months, and 6 months postoperatively based on outpatient follow-up records. The primary outcomes were healing rate and recurrence rate. Secondary outcomes were 30-day morbidity, postoperative complications, and incontinence using the Wexner score.Results: Eighteen patients (90%) had a preoperative diagnosis of complex fistula, and 13 patients (65%) had undergone a previous fistula surgery. Primary healing rate was 55% at 1 month, 63.16% at 3 months, and 78.95% at 6 months postoperatively. Eighteen patients (94.74%) maintained continence (Wexner score = 0) at 6 months.Conclusion: Our study results suggest that VAAFT is a safe, minimally invasive technique for treatment of anal fistula and can preserve anal sphincter function. The technique has an acceptable healing rate with minimal complications.

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Section: Discussionmentioning

confidence: 99%

Initial Experience With Video-Assisted Anal Fistula Treatment in the Philippines

2020

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“…24 Another series by the same authors reported results of 50 patients, and reported a recurrence rate of 7%, with minor control problems in 40%. 25 Primary fistulotomy with end-to-end primary sphincteroplasty is another treatment option. In 2013, Ratto et al reported on this technique for 72 patients with complex anal fistula of cryptoglandular origin.…”

Section: Fistulotomymentioning

confidence: 99%

Management of Complex Anal Fistulas

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Cologne

2016

Clinics in Colon and Rectal Surgery

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“…Fistulectomy is usually recommended for low anal fistulas, as the success rate is high with this procedure, and with minimal incontinence. The success rates can be as high as 93 to 100 % in experienced hands [28,29]. The incontinence is usually minor and can range from 11.5 to 20 %.…”

Section: Fistulectomymentioning

confidence: 98%