Quality of Life Following Anal Fistula Treatment

2021 ◽  
pp. 1-9
Author(s):  
Dieter Hahnloser
Keyword(s):  
Quality Of Life ◽  
Anal Fistula ◽  
Fistula Treatment

scholarly journals Video-assisted anal fistula treatment versus fistulectomy and sphincter repair in the treatment of high cryptoglandular anal fistula: a randomized clinical study

BJS Open ◽  
2021 ◽  
Vol 5 (5) ◽  
Author(s):  
Karam M Sørensen ◽  
Sören Möller ◽  
Niels Qvist
Keyword(s):  
Quality Of Life ◽  
Recurrence Rate ◽  
Anal Fistula ◽  
Anal Manometry ◽  
Single Centre ◽  
Recurrence Rates ◽  
Wexner Score ◽  
Faecal Continence ◽  
Fistula Treatment

Abstract Background Video-assisted anal fistula treatment (VAAFT) may have a recurrence rate comparable to that of fistulectomy and sphincter repair (FSR) in the treatment of high anal fistula and with potential advantages in wound healing, functional outcome and quality of life. The aim and objectives of the study are to compare the outcome of VAAFT with that of FSR for high cryptoglandular anal fistula. Methods This was a single-centre randomized controlled trial of adults with high anal fistula comparing FSR with VAAFT. Primary outcome was fistula recurrence. Secondary outcomes were results of anal manometry, quality of life and faecal continence. A power calculation of 33 patients in each arm (1 : 1) was based on recurrence in the FSR and VAAFT groups of 5 per cent and 30 per cent respectively. Follow-up at 6 months after surgery included physical examination, MRI, anal manometry, quality-of-life assessment (RAND SF 36 questionnaire) and faecal-continence assessment (Wexner score). Results The study was terminated early due to high recurrence rates in both groups. A total of 45 patients were included. Recurrence rates were 65 per cent for VAAFT and 27 per cent for FSR, with hazard ratio 4.18 (P = 0.016). Length of the fistula was a risk factor with an association with recurrence (hazard ratio 1.8, P = 0.020). There were significant differences in quality of life in favour of FSR and in anal manometry in favour of VAAFT with a significant improvement in Wexner score in both groups. Conclusion FSR was associated with a lower recurrence rate than VAAFT in the management of complex anal fistulae in this single-centre study but the study was terminated early due to higher than predicted recurrence rate in both groups. Registration number NCT02585167 (http://www.clinicaltrials.org).

scholarly journals Design and Psychometric Evaluation of the Quality of Life in Patients With Anal Fistula Questionnaire

2017 ◽  
Vol 60 (10) ◽  
pp. 1083-1091 ◽  
Author(s):  
Manuel Ferrer-Márquez ◽  
Natalia Espínola-Cortés ◽  
Angel Reina-Duarte ◽  
José Granero-Molina ◽  
Cayetano Fernández-Sola ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Anal Fistula ◽  
Psychometric Evaluation

scholarly journals Analysis and Description of Disease-Specific Quality of Life in Patients With Anal Fistula

2018 ◽  
Vol 96 (4) ◽  
pp. 213-220
Author(s):  
Manuel Ferrer-Márquez ◽  
Natalia Espínola-Cortés ◽  
Ángel Reina-Duarte ◽  
José Granero-Molina ◽  
Cayetano Fernández-Sola ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Anal Fistula ◽  
Disease Specific

scholarly journals Development and initial psychometric validation of a patient-reported outcome measure for Crohn’s perianal fistula: the Crohn’s Anal Fistula Quality of Life (CAF-QoL) scale

Gut ◽  
2020 ◽  
pp. gutjnl-2019-320553
Author(s):  
Samuel O Adegbola ◽  
Lesley Dibley ◽  
Kapil Sahnan ◽  
Tiffany Wade ◽  
Azmina Verjee ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Construct Validity ◽  
Anal Fistula ◽  
Outcome Measure ◽  
Perianal Fistula ◽  
Patient Reported Outcome ◽  
Patient Reported Outcome Measure ◽  
Patient Reported ◽  
The Uk

IntroductionCrohn’s perianal fistulas are challenging for patients and clinicians. Many do not respond to available treatments and despite recommendations by a global consensus, there are currently no specific patient-derived quality of life tools to measure response to treatment. We present a new validated patient-reported outcome measure (PROM) for this complicated disease phenotype.MethodsA draft questionnaire was generated using unstructured qualitative patient interviews on the experience of living with Crohn’s perianal fistula, a nationwide multidisciplinary consensus exercise, a systematic review of outcomes assessing medical/surgical/combined treatment and a patient and public involvement day. Psychometric properties were assessed including construct validity (by comparison with the Hospital Anxiety and Depression Scale (HADS) and the UK Inflammatory Bowel Disease Questionnaire (UK-IBDQ)), and reliability and responsiveness was assessed by test–retest analysis.ResultsData from 211 patients contributed to development of a final 28-item questionnaire. The Crohn’s Anal Fistula Quality of Life (CAF-QoL) demonstrated good internal consistency (Cronbach’s alpha 0.88), excellent stability (intraclass correlation 0.98) and good responsiveness and construct validity, with positive correlation with the UK-IBDQ and HADS.ConclusionThe CAF-QoL scale is ready for use as a PROM in research and clinical practice. It complements objective clinical evaluation of fistula by capturing impact on the patient.

The type of loose seton for complex anal fistula is essential to improve perianal comfort and quality of life

2016 ◽  
Vol 18 (6) ◽  
pp. O194-O198 ◽  
Author(s):  
I. Kristo ◽  
A. Stift ◽  
C. Staud ◽  
A. Kainz ◽  
T. Bachleitner-Hofmann ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Anal Fistula ◽  
Complex Anal Fistula

Quality of life of patients after surgical treatment of anal fistula; the role of anal manometry

2001 ◽  
Vol 3 (6) ◽  
pp. 417-421 ◽  
Author(s):  
E. Mylonakis ◽  
C. Katsios ◽  
D. Godevenos ◽  
B. Nousias ◽  
A. M. Kappas
Keyword(s):  
Quality Of Life ◽  
Surgical Treatment ◽  
Anal Fistula ◽  
Anal Manometry

scholarly journals N001 Developing a quality of life score for Crohn’s anal fistula (CAF-QoL)

2018 ◽  
Vol 12 (supplement_1) ◽  
pp. S568-S568 ◽  
Author(s):  
S Adegbola ◽  
L Dibley ◽  
K Sahnan ◽  
P Tozer ◽  
N Yassin ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Anal Fistula ◽  
Life Score

Anal fistula plug: a prospective evaluation of success, continence and quality of life in the treatment of complex fistulae

2014 ◽  
Vol 16 (7) ◽  
pp. 547-554 ◽  
Author(s):  
M. Adamina ◽  
T. Ross ◽  
M. O. Guenin ◽  
R. Warschkow ◽  
C. Rodger ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Anal Fistula ◽  
Prospective Evaluation ◽  
Fistula Plug ◽  
Anal Fistula Plug

scholarly journals Quality of life with anal fistula

2016 ◽  
Vol 98 (5) ◽  
pp. 334-338 ◽  
Author(s):  
HA Owen ◽  
GN Buchanan ◽  
A Schizas ◽  
R Cohen ◽  
AB Williams
Keyword(s):  
Quality Of Life ◽  
Anal Fistula ◽  
Recurrent Disease ◽  
Short Form ◽  
Factors Affecting ◽  
Incontinence Score ◽  
Sf 36 ◽  
Working Age ◽  
Faecal Continence

Introduction Anal fistula affects people of working age. Symptoms include abscess, pain, discharge of pus and blood. Treatment of this benign disease can affect faecal continence, which may, in turn, impair quality of life (QOL). We assessed the QOL of patients with cryptoglandular anal fistula. Methods Newly referred patients with anal fistula completed the St Mark’s Incontinence Score, which ranges from 0 (perfect continence) to 24 (totally incontinent), and Short form 36 (SF–36) questionnaire at two institutions with an interest in anal fistula. The data were examined to identify factors affecting QOL. Results Data were available for 146 patients (47 women), with a median age of 44 years (range 18–82 years) and a median continence score of 0 (range 0–23). Versus population norms, patients had an overall reduction in QOL. While those with recurrent disease had no difference on continence scores, QOL was worse on two of eight SF–36 domains (p<0.05). Patients with secondary extensions had reduced QOL in two domains (p<0.05), while urgency was associated with reduced QOL on five domains (p<0.05). Patients with loose seton had the same QOL as those without seton. No difference in urgency was found between patients with and without loose seton. In primary fistula patients, 19.4% of patients experienced urgency versus 36.3% of those with recurrent fistulas. Conclusions Patients with anal fistula had a reduced QOL, which was worse in those with recurrent disease, secondary extensions and urgency. Loose seton had no impact on QOL.

scholarly journals Sphincter Preserving Techniques in Anal Fistula Treatment

2021 ◽  
Author(s):  
Dorian Kršul ◽  
Damir Karlović ◽  
Đordano Bačić ◽  
Marko Zelić
Keyword(s):  
Anal Fistula ◽  
Advancement Flap ◽  
High Rate ◽  
Fistula Tract ◽  
Colorectal Surgeon ◽  
Intersphincteric Fistula ◽  
Fistula Treatment ◽  
Meta Analyses ◽  
Methods Of Treatment

Complex anal fistulas present a challenge to even a seasoned colorectal surgeon due to high rate of recurrence and a real possibility of fecal incontinence if treated with conventional methods (e.g., fistulotomy, fistulectomy, seton placement). Although the illness is benign in nature, it can significantly decrease patient’s quality of life because of symptoms like pain and soiling. Given those facts, minimally invasive or sphincter preserving methods of treatment were introduced. Some of these include: Video-assisted anal fistula treatment (VAAFT), ligation of intersphincteric fistula tract (LIFT), Fistula-tract laser closure (FILAC), rectal advancement flap (RAF), treatment with platelet cells and combinations of techniques. This chapter would be an overview of these novel techniques with reference to latest clinical trials and meta-analyses.

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