Video-Assisted Anal Fistula Treatment

Kochhar, Gaurav; Saha, Sudipta; Andley, Manoj; Kumar, Abhishek; Saurabh, Gyan; Pusuluri, Rahul; Bhise,

doi:10.4293/jsls.2014.00127

Cited by 36 publications

(14 citation statements)

References 25 publications

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“…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]. Complex fistulas-in-ano include high transsphincteric, suprasphincteric, and extrasphincteric fistulas (tract crosses 30%-50% of the external sphincter); anterior fistulas in females; fistulas with multiple tracts; or patients with pre-existing incontinence, a history of local irradiation, or Crohn disease [11].…”

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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“…Its minimally invasive and also both diagnostic and therapeutic. 26 in VAAFT there is no cutting of sphincter muscles. 27 Fistulous tract is just probed, under video guidance entire tract is cauterized and scraped of its infected epithelium, abscess if any drained, and internal opening ligated under vision.…”

Section: Discussionmentioning

confidence: 99%

VAAFT versus fistulectomy in the management of anorectal fistulae: a comparative study?

Venkatapuram

Sateesh

2017

Int Surg J

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Background: Among the perianal diseases Fistula in ano is a very common condition bringing lot of discomfort to the patient with a high rate of recurrence as well. Conventionally fistulectomy has been the treatment of choice for fistula-in-ano. But the procedure is associated with lot of recurrence, morbidity and sphincter incontinence. Among several recent procedures VAAFT-video assisted anal fistula treatment is gaining popularity. So, we conducted this study to know the effectiveness of VAAFT over conventional fistulectomy. Methods: This prospective comparative study was undertaken to compare VAAFT and fistulectomy in the management of fistula-in-ano. A one-year study was carried out on 50 patients from mid-2015 to 2016. A visual analogue scale (VAS) was used to assess pain in the postoperative period. All patients were observed for one-year period for any recurrence of disease. Results were statistically analysed by SPSS 15.0 software. Results: two groups were formed among the 50 patients selected for study. There was male preponderance in both the groups. majority of patients belonged to 31-40 years of age group. Majority of the patients had low anal fistulae followed by patients with high anal fistulae and anorectal fistulae in that order. There was recurrence of disease in 12% of people operated by fistulectomy whereas it was only 1% in group who underwent VAAFT. Conclusions: VAAFT procedure offered significantly less recurrence rates in comparison with fistulectomy. There was less postoperative pain and nil complications after surgery. Patient satisfaction was high. Our study concluded VAAFT as a safe and effective procedure alternative to conventional fistulectomy.

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“…The most widely used classification for fistula in ano is the Park classification, which distinguishes four kinds of fistula: intersphincteric, transsphincteric, suprasphincteric and extrasphincteric [8]. Fistulae are also be classified as low fistula and high fistula, depending on the level of the internal opening below or above the anorectal ring [9]. There are many surgical procedures advocated for fistula in ano, ranging from simply laying open the tract to colostomy.…”

Section: Discussionmentioning

confidence: 99%

“…The use of fibrin glue injection for treatment of fistula in ano is described with advantages of its reproducibility. The long-term success rates range from 14% to 69% [9,11]. The transanal rectal advancement flap technique is described for treatment of high perianal fistula.…”

Section: Discussionmentioning

confidence: 99%

Skin Sparing Fistulectomy with Primary Sphincters Repair by Special Sutures for Management of High Perianal Fistula

Lasheen¹

2016

J Surg Surgical Res

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Background: Fistula in ano is a common disease seen in the surgical outpatient department. Many procedures are advocated for the treatment of fistula in ano. However, none of the procedures is considered the gold standard. Aim of this study was to evaluate our procedure in the managing high perianal fistula. Methods:Between February 2014 and September 2015, 71 patients with high perianal fistula were managed by skin sparing fistulectomy and special sutures for primary repair of anal sphincters. The clinical outcome was assessed in terms of time for healing, continence and recurrence for followup period (ranged from 4 to 24 months).Results: Anorectal wounds were healed within 3 to 4 weeks. Complications included urine retention 9 patients (12.7 %), superficial wound infection 29 patients (40.9 %), and transient incontinence 33 patients (46.5 %) for flatus for period ranged from 2 to 3 weeks. No deep infection, no permanent incontinence were recorded. Recurrence was in one patient (1.4 %). Conclusion:Our technique is less invasive, rapid healing, maintain on normal configuration of anus, and associated with good results for high perianal fistula management.

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Video-Assisted Anal Fistula Treatment

Cited by 36 publications

References 25 publications

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

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

VAAFT versus fistulectomy in the management of anorectal fistulae: a comparative study?

Skin Sparing Fistulectomy with Primary Sphincters Repair by Special Sutures for Management of High Perianal Fistula

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