“Video-assisted anal fistula treatment (VAAFT): a novel sphincter-saving procedure to repair complex anal fistulas” by Piercarlo Meinero and Lorenzo Mori

Zbar, Andrew P.

doi:10.1007/s10151-011-0771-8

Cited by 7 publications

(8 citation statements)

References 10 publications

(7 reference statements)

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“…Furthermore, soon after Meinero's publication, several comments appeared [19, 20], pointing out potential flaws of endoscopic treatment using the fistuloscope. Parks et al noted that perianal fistulas come in various shapes and sizes, and due to anatomical construction and the relations of pelvic structures, the tract is often curved [21]; therefore, it is often difficult to explore the entire tract of the fistula using a rigid instrument.…”

Section: Discussionmentioning

confidence: 99%

Video-Assisted Anal Fistula Treatment: Pros and Cons of This Minimally Invasive Method for Treatment of Perianal Fistulas

Romaniszyn

Wałęga

2017

Gastroenterology Research and Practice

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Purpose The purpose of this paper is to present results of a single-center, nonrandomized, prospective study of the video-assisted anal fistula treatment (VAAFT). Methods 68 consecutive patients with perianal fistulas were operated on using the VAAFT technique. 30 of the patients had simple fistulas, and 38 had complex fistulas. The mean follow-up time was 31 months. Results The overall healing rate was 54.41% (37 of the 68 patients healed with no recurrence during the follow-up period). The results varied depending on the type of fistula. The success rate for the group with simple fistulas was 73.3%, whereas it was only 39.47% for the group with complex fistulas. Female patients achieved higher healing rates for both simple (81.82% versus 68.42%) and complex fistulas (77.78% versus 27.59%). There were no major complications. Conclusions The results of VAAFT vary greatly depending on the type of fistula. The procedure has some drawbacks due to the rigid construction of the fistuloscope and the diameter of the shaft. The electrocautery of the fistula tract from the inside can be insufficient to close wide tracts. However, low risk of complications permits repetition of the treatment until success is achieved. Careful selection of patients is advised.

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Section: Discussionmentioning

confidence: 99%

Video-Assisted Anal Fistula Treatment: Pros and Cons of This Minimally Invasive Method for Treatment of Perianal Fistulas

Romaniszyn

Wałęga

2017

Gastroenterology Research and Practice

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“…6 A number of studies have shown the efficacy and safety of video-assisted surgery for pilonidal sinus and anal fistula 5-9 but we are the first to report the utility of endoscopic surgery in the acute setting for the treatment of pilonidal abscesses. Fahrni et al 10 reported a relapse rate of 38.9% after incision and drainage of pilonidal abscess and, although the number of patients in our cohort are small, no patients required emergency admission within 6 weeks following EPAT and ten patients (71 %) did not require any further definitive procedure for the duration of follow-up.…”

Section: Discussionmentioning

confidence: 92%

“…5 Video-assisted anal fistula treatment is now recognised as an effective and safe treatment for anal fistula and is associated with reduced morbidity. 6 We report our initial experience of applying the principles of video-assisted surgery for the treatment of acute pilonidal abscesses -endoscopic pilonidal abscess treatment (EPAT). The rationale for this technique is to perform a thorough washout of the abscess cavity using a small incision followed by ablation of the cavity under direct vision using the fistuloscope.…”

Section: Introductionmentioning

confidence: 99%

Endoscopic pilonidal abscess treatment: a novel approach for the treatment of pilonidal abscess

Jain

Javed

Singh

et al. 2017

annals

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INTRODUCTION Pilonidal abscess is a common surgical emergency. Conventional treatment with incision and drainage is associated with significant postoperative morbidity. We report our initial experience of using minimally invasive endoscopic technique for the treatment of pilonidal abscesses, referred to as endoscopic pilonidal abscess treatment (EPAT). MATERIALS AND METHODS A prospective database of all patients undergoing EPAT between January 2015 and March 2016 at Whiston Hospital was maintained. Data regarding patient demographics, peroperative variables and postoperative follow-up were recorded. RESULTS Nineteen patients were included, male to female ratio was 53 : 47 and median age of the cohort was 24 years (interquartile range 22-25 years). EPAT was the primary procedure for 10 patients and 9 had EPAT for recurrent pilonidal abscesses. There were no readmissions and none needed further surgery within 6 weeks of having the procedure. In all patients, complete wound healing was achieved within 6 weeks; all reported minimal postoperative pain (median postoperative visual analogue scale score 1) and immediate return to the activities of daily life. Four of the nineteen patients (21%) required definitive intervention for pilonidal disease in the follow-up period. CONCLUSIONS EPAT is a novel, minimally invasive technique for the treatment of acute pilonidal abscesses. It is safe, associated with reduced postoperative morbidity, recurrence rate and quick wound healing. Initial encouraging results require further investigations on a larger group of patients in a multicentre setting.

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“…Low intersphincteric and transsphincteric tracts are usually treated with fistulotomy or fistulectomy. High fistulas that involve more than 30% of the IAS or EAS, and suprasphincteric and extrasphincteric fistulas need sphincter-saving procedures in order to prevent faecal incontinence [13,[16][17][18]. The introduction of the 3D technique has optimized ultrasound evaluation [10,19,20].…”

Section: Discussionmentioning

confidence: 99%

Three‐dimensional endoanal ultrasound is accurate and reproducible in determining type and height of anal fistulas

Kołodziejczak¹,

Santoro

Obcowska

et al. 2017

Colorectal Disease

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“Video-assisted anal fistula treatment (VAAFT): a novel sphincter-saving procedure to repair complex anal fistulas” by Piercarlo Meinero and Lorenzo Mori

Cited by 7 publications

References 10 publications

Video-Assisted Anal Fistula Treatment: Pros and Cons of This Minimally Invasive Method for Treatment of Perianal Fistulas

Video-Assisted Anal Fistula Treatment: Pros and Cons of This Minimally Invasive Method for Treatment of Perianal Fistulas

Endoscopic pilonidal abscess treatment: a novel approach for the treatment of pilonidal abscess

Three‐dimensional endoanal ultrasound is accurate and reproducible in determining type and height of anal fistulas

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