scholarly journals Video Assisted Anal Fistula Treatment, a Paradigm Shift in the Treatment of Complex Anal Fistulas

2021 ◽  
Vol 8 (06) ◽  
pp. 313-318
Author(s):  
Anshu Atreya ◽  
Ankit Raikhy ◽  
Srinivasa Rao Geddam ◽  
Abhishekh Bhartia ◽  
Vishnu Kumar Bhartia
Keyword(s):  
Anal Fistula ◽  
Small Subset ◽  
Internal Opening ◽  
Anal Fistulas ◽  
Fistula In Ano ◽  
Video Assisted ◽  
Wide Range ◽  
Ancient Times ◽  
Fistula Treatment ◽  
Complex Anal Fistulas

BACKGROUND Fistula-in-ano or anal fistulas are documented since ancient times and their management has always been a challenge. Various modalities of treatment are available and newer ones are being added each day. The aim of this retrospective study is to analyse the outcome of the video assisted anal fistula treatment (VAAFT), one of the modalities of treatment for complex anal fistulas done at our centre. METHODS Records of patients who had been treated through VAAFT by single senior consultant surgeon of Minimal Access Surgery unit between April 2013 and March 2019, were collected and analysed. RESULTS Altogether, records of 48 (forty-eight) patients who had undergone VAAFT during the period were analysed. Data revealed that 38 male (79.17 %) and 10 female (20.83 %) patients with mean age of 49.96 ± 12.22 years were operated. Most commonly, trans sphincteric followed by inter sphincteric type of fistulae were encountered. In 3 cases, internal opening couldn’t be visualised. Six patients were documented to have a recurrence within 6 months of the procedure and in the rest were cured except in a small subset of patients who did not follow up. CONCLUSIONS Amongst the wide range of armamentarium available today for the treatment of complex anal fistulas, video assisted anal fistula treatment (VAAFT) is a novel sphincter saving technique. The recurrence rate at our centre was at par with other studies and with zero incontinence rate, however further RCTs are required. KEYWORDS Complex Anal Fistula, Fistula-in-Ano, MEINERO Fistuloscope, VAAFT

scholarly journals Role of video assisted anal fistula treatment in our management of fistula-in-ano

2014 ◽  
Vol 61 (2) ◽  
pp. 83-85 ◽  
Author(s):  
Tomáas Grolich ◽  
Tomás Skricka ◽  
Oldøich Robek ◽  
Zdenìk Kala ◽  
Beata Hemmelová ◽  
...  
Keyword(s):  
Anal Fistula ◽  
Perianal Fistula ◽  
Internal Opening ◽  
Fistula In Ano ◽  
Chronic Fistula ◽  
Video Assisted ◽  
Seton Drainage ◽  
Fistula Treatment ◽  
Established Role

Background: Video-assisted anal fistula treatment is a new method used for treatment of complex perianal fistula with maximal sparing of sphincter muscles and prevention of false route. Authors inform about their experience and operative results. Aims: Our aim was to verify feasibility of the method, help in internal opening identification and define its position in our management of perianal fistulas. Methods: Patients with chronic fistula-in-ano of IBD and non-IBD benign etiology were enrolled. Anoscopy with fistuloscopy was attempted in all patients followed by loose seton drainage or other procedure. Results: Fistuloscopy was attempted in 30 patients, finished in 93% and internal opening was found in 67%. No procedure-related morbidity was observed. Conclusion: Fistuloscopy alone is feasible for diagnosing type of IBD and non-IBD fistulas. VAAFT technique and instruments were helpful for identification of an internal opening in most cases. As such it has established role in our management of fistula-in-ano.

scholarly journals Efficacy of video-assisted anal fistula treatment combined with closure of the internal opening using a stapler for Parks II anal fistula

2020 ◽  
Vol 8 (22) ◽  
pp. 1517-1517
Author(s):  
Yuru Zhang ◽  
Fei Li ◽  
Tuanjie Zhao ◽  
Feng Cao ◽  
Yamin Zheng ◽  
...  
Keyword(s):  
Anal Fistula ◽  
Internal Opening ◽  
Video Assisted ◽  
Fistula Treatment

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

2020 ◽  
Vol 36 (2) ◽  
pp. 112-118
Author(s):  
Marc Paul J. Lopez ◽  
Mark Augustine S. Onglao ◽  
Hermogenes J. Monroy III
Keyword(s):  
Postoperative Complications ◽  
Anal Fistula ◽  
Healing Rate ◽  
The Philippines ◽  
Invasive Technique ◽  
Internal Opening ◽  
Video Assisted ◽  
Study Results ◽  
Fistula Treatment ◽  
Opening Method

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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