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

Abstract

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.

Long term efficacy of Video‐Assisted Anal Fistula Treatment (VAAFT) for complex fistula‐in‐ano: a single‐centre Australian experience

“…In our study, the rate of primary healing was lower than that seen in the two VAAFT meta‐analyses performed to date (covering 12 individual studies) which reported pooled rates of healing of 82.3% at 9 months median follow up 19 and 76% at 7 months follow up 22 . Studies performed since these reviews have demonstrated primary healing rates ranging from 54% to 81% at follow up ranging from 6 to 36 months 23–28 . The lower rate of primary healing witnessed in our study is perhaps explained by the complexity of included disease, but also the longer duration of follow up (mean 59.5 months).…”

“…22 Studies performed since these reviews have demonstrated primary healing rates ranging from 54% to 81% at follow up ranging from 6 to 36 months. [23][24][25][26][27][28] The lower rate of primary healing witnessed in our study is perhaps explained by the complexity of included disease, but also the longer duration of follow up (mean 59.5 months). The latter is an important consideration as the rate of recurrence of FIA is known to increase out to 5 years post intervention.…”

Research on high anal fistula: a bibliometric analysis

“…VAAFT is an emerging treatment method that brings hope to the treatment of anal fistula (26). It is still unclear whether video assistance is critical to the success of the surgery; some supporters believe that even the lesions missed by MRI can be found using VAAFT.…”

Rectal Fistulas: Current State of the Problem

“…У одного пациента зарегистрирован рецидив свища. У одного пациента во время контрольного осмотра через 6 месяцев установлена инконтиненция с недержанием газов и стула [11].…”