Preliminary results of video-assisted anal fistula treatment (VAAFT) in children

Prato, Alessio Pini; Zanaboni, Clelia; Mosconi, Manuela; Mazzola, Cinzia; Muller, L.; Meinero, Piercarlo; Faticato, Maria Grazia; Leonelli, Lorenzo; Montobbio, Giovanni; Disma, Nicola; Mattioli, Girolamo

doi:10.1007/s10151-016-1447-1

Cited by 19 publications

(3 citation statements)

References 16 publications

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“…The VAAFT technique can preserve the anal sphincter because the fistula is treated by endoscopy without fistulotomy or fistulectomy, efficiently avoiding injury to the anal sphincter. Recently, many scholars have begun to implement this method to treat anal fistulae, 9,13-16 including pediatric anal fistulae and anal fistulae associated with Crohn’s disease. The results exhibited in these studies support the conclusion that VAAFT is a safe and efficient surgical method to preserve the anal sphincter and an alternative approach for anal fistula treatment.…”

Section: Discussionmentioning

confidence: 99%

Treatment of Complex Anal Fistula by Video-Assisted Anal Fistula Treatment Combined with Anal Fistula Plug: A Single-Center Study

Zhang¹,

Zhao³

et al. 2021

Surg Innov

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Objective. The surgical treatment of complex anal fistulae is very challenging because of the incidence of incontinence after traditional approaches. There are no studies on the role of video-assisted anal fistula treatment (VAAFT) combined with anal fistula plug (AFP) in the complex anal fistulae. The aim of this study was to demonstrate the efficacy of treating complex anal fistulae using VAAFT combined with AFP. Method. This was a retrospective, nonrandomized observational study. 57 consecutive patients with complex anal fistulae who had undergone the VAAFT with AFP in our hospital between April 2016 and December 2019 were included. The primary outcomes were the cure rate, recurrence rate, and Wexner incontinence scores; the secondary outcomes were surgery time, blood loss, wound healing time postoperatively, pain, and patient satisfaction. Results. All 57 patients completed the surgery and follow-up, with an average follow-up time of 28 months; 6 patients suffered with recurrence (recurrence rate: 10.5%). The average surgery time was 57.9 minutes, and the average wound healing time was 46 days. There were no severe postoperative complications, and anal sphincter function was protected in all patients. Conclusions. The treatment of complex anal fistula by VAAFT combined with AFP is safe and effective, has a high healing rate and few postoperative complications, and is a promising surgery that can effectively protect the patient’s anal sphincter function.

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Section: Discussionmentioning

confidence: 99%

Treatment of Complex Anal Fistula by Video-Assisted Anal Fistula Treatment Combined with Anal Fistula Plug: A Single-Center Study

Zhang¹,

Zhao³

et al. 2021

Surg Innov

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“…At a mean follow‐up of 9 months 9 of 11 patients, where VAAFT was technically possible, were deemed a success, and no deterioration in continence was observed. VAAFT has also been reported in a paediatric population . Thirteen procedures were performed on nine children (mean age 9.6 years).…”

Section: Treatmentmentioning

confidence: 96%

The treatment of anal fistula: secondACPGBIPosition Statement – 2018

Williams

Tozer

et al. 2018

Colorectal Disease

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“…The procedure rapidly gained popularity worldwide; it is also expanded [60] in the pediatric population and anal CD, which may be combined [61] with RAF. There is [62] a palliative effect in the main local anal symptoms, such as pain and discharge, in patients with anal CD and complex refractory AF undergoing VAAFT.…”

Section: Vaaftmentioning

confidence: 99%

Surgery of Simple and Complex Anal Fistulae in Adults: A Review of the Literature for Optimal Surgical Outcomes

Charalampopoulos¹,

Papakonstantinou²,

Bagias³

et al. 2023

Cureus

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Anal fistulas are common anorectal conditions, and surgery is the primary treatment option. In the last 20 years of literature, there exist a large number of surgical procedures, especially for the treatment of complex anal fistulas, as they present more recurrences and continence problems than simple anal fistulas. To date, there are no guidelines for choosing the best technique. We conducted a recent literature review, mainly the last 20 years, based on the PubMed and Google Scholar medical databases, with the goal of identifying the surgical procedures with the highest success rates, lowest recurrence rates, and best safety profiles. Clinical trials, retrospective studies, review articles, comparative studies, recent systematic reviews, and metaanalyses for various surgical techniques, as well as the latest guidelines of the American Society of Colon and Rectal Surgeons, the Association of Coloproctology of Great Britain and Ireland, and the German S3 guidelines on simple and complex fistulas were reviewed.According to the literature, there is no recommendation for the optimal surgical technique. The etiology, complexity, and many other factors affect the outcome. In simple intersphincteric anal fistulas, fistulotomy is the procedure of choice. In simple low transsphincteric fistulas, the patient's selection is crucial in order to perform a safe fistulotomy or another sphincter-saving technique. The healing rate in simple anal fistulas is higher than 95% with low recurrence and without significant postoperative complications. In complex anal fistulas, only sphincter-saving techniques should be used; the optimal outcomes are obtained by the ligation of the intersphincteric fistulous tract (LIFT) and rectal advancement flaps. Those techniques assure high healing rates of 60-90%. The novel technique of the transanal opening of the intersphincteric space (TROPIS) is under evaluation. The novel sphincter-saving techniques of fistula laser closure (FiLac) and video-assisted anal fistula treatment (VAAFT) are safe, with reported healing rates ranging from 65% to 90%. Surgeons should be familiar with all sphincter-saving techniques in order to face the variability of the fistulas-in-ano. Currently, there is no universally superior technique that can treat all fistulas.

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Preliminary results of video-assisted anal fistula treatment (VAAFT) in children

Cited by 19 publications

References 16 publications

Treatment of Complex Anal Fistula by Video-Assisted Anal Fistula Treatment Combined with Anal Fistula Plug: A Single-Center Study

Treatment of Complex Anal Fistula by Video-Assisted Anal Fistula Treatment Combined with Anal Fistula Plug: A Single-Center Study

The treatment of anal fistula: secondACPGBIPosition Statement – 2018

Surgery of Simple and Complex Anal Fistulae in Adults: A Review of the Literature for Optimal Surgical Outcomes

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