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 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 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 Study the Role of Loose versus cutting of Seton in Treatment of High Perianal fistula in a District Hospital of Health Insurance

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
M S Abdelhameed ◽  
I M H Elghazawy ◽  
E A Elsayed
Keyword(s):  
Anal Fistula ◽  
Low Cost ◽  
Perianal Fistula ◽  
Dentate Line ◽  
Internal Opening ◽  
Fistula In Ano ◽  
One Year ◽  
Definition Of ◽  
A Prospective Study ◽  
High Perianal Fistula

Abstract When the track reaches the skin or another epithelialized surface then a fistula is formed. Anal fistula were classified on the basis of its relationship to the sphincters. The definition of high or low describes the height of the track as it traverses the sphincter muscles and not the position of the internal opening which is almost without exception at the dentate line. More accurately according to parks classification fistula in ano can result in an abscess between the internal and external sphincters, which in turn can spread to other parts of the perianal region. Infection can then track in many directions from this focus in the intersphincteric plane. Background Anal fistula is an abnormal communicative small channel that has an internal opening and an external opening and connected by the primary track. Our study evaluate the effectiveness of seton in high variety anal fistula. Objectives Evaluation the efficacy and safety of seton as surgical management of high anal fistula. Methods: This is a prospective study done on 30 patients in ELNile hospital in one Year period with high variety of anal fistula which is above the dentate line and were treated with seton .Outcome measured during follow up period were- successfully healed, recurrence, incontinence, percentage of complications and patients satisfaction. Result Among 30 patients mean age was 42.2+_6.8 years. Overall outcome of the patients showed-fistula completely healed in 27 patients, incontinence occurred in 3 patients and recurrence occurred in 3 patients. Conclusion Seton is relatively safe, effective and low cost for the management of high anal fistula with low rate of incontinence. It can therefore, be recommended as the standard of treatment for high variety fistula in ano.

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.

scholarly journals Video-assisted anal fistula treatment: technical considerations and preliminary results of the first brazilian experience

2014 ◽  
Vol 27 (1) ◽  
pp. 77-81 ◽  
Author(s):  
Carlos Ramon Silveira MENDES ◽  
Luciano Santana de Miranda FERREIRA ◽  
Ricardo Aguiar SAPUCAIA ◽  
Meyline Andrade LIMA ◽  
Sergio Eduardo Alonso ARAUJO
Keyword(s):  
Anal Fistula ◽  
Fistula Tract ◽  
Anorectal Fistula ◽  
Treatment Technique ◽  
Internal Opening ◽  
Direct Closure ◽  
Invasive Approach ◽  
Internal Fistula ◽  
Video Assisted ◽  
Fistula Treatment

Backgroung : Anorectal fistula represents an epithelized communication path of infectious origin between the rectum or anal canal and the perianal region. The association of endoscopic surgery with the minimally invasive approach led to the development of the video-assisted anal fistula treatment. Aim : To describe the technique and initial experience with the technique video-assisted for anal fistula treatment. Technique : A Karl Storz video equipment was used. Main steps included the visualization of the fistula tract using the fistuloscope, the correct localization of the internal fistula opening under direct vision, endoscopic treatment of the fistula and closure of the internal opening which can be accomplished through firing a stapler, cutaneous-mucosal flap, or direct closure using suture. Results : The mean distance between the anal verge and the external anal orifice was 5.5 cm. Mean operative time was 31.75 min. In all cases, the internal fistula opening could be identified after complete fistuloscopy. In all cases, internal fistula opening was closed using full-thickness suture. There were no intraoperative or postoperative complications. After a 5-month follow-up, recurrence was observed in one (12.5%) patient. Conclusion : Video-assisted anal fistula treatment is feasible, reproducible, and safe. It enables direct visualization of the fistula tract, internal opening and secondary paths.

A Prospective Study on treatment of Perianal Fistula by Video Assisted Anal Fistula Treatment (VAAFT)

2017 ◽  
Vol 8 (3) ◽  
pp. 373-376
Author(s):  
Ramkrishna Darji ◽  
◽  
Samir M. Shah ◽  
Vikram B. Gohil ◽  
Ramesh Kumar Verma ◽  
...  
Keyword(s):  
Prospective Study ◽  
Anal Fistula ◽  
Perianal Fistula ◽  
Video Assisted ◽  
Fistula Treatment ◽  
A Prospective Study

scholarly journals Role of magnetic resonance imaging in diagnosis and grading of perianal fistulas

2021 ◽  
Vol 12 (12) ◽  
pp. 140-146
Author(s):  
Saurabh S Kakani ◽  
Devidas B Dahiphale ◽  
Saurabh G Padiya ◽  
Vimal G Dugad ◽  
Shivaji M Pole ◽  
...  
Keyword(s):  
Mr Imaging ◽  
Anal Canal ◽  
Fistulous Tract ◽  
Perianal Fistula ◽  
Internal Opening ◽  
Perianal Area ◽  
Fistula In Ano ◽  
Perianal Fistulae ◽  
Transmural Inflammation

Background: Fistula-in-ano can be defined as a hollow tract or cavity which is lined by granulation tissue. In case of fistula-in-ano, one end of this fistula opens in the anal canal whereas the other end is located in perianal area. Fistula-in-ano can considerably affect quality of life of an individual because of perianal discharge of blood and pus. Imaging of these fistulas is an important part of management and MR imaging is important in assessing relationship between the fistulous tract and sphincter muscles. Moreover, MR imaging can reliably demonstrate transmural inflammation, secondary tracts/ramifications, and abscesses which cannot be diagnosed on the basis of conventional fistulography. Aims and Objectives: The aim of the study was to evaluate role of MRI in diagnosis and grading of perianal fistulae. Materials and Methods: This was a retrospective observational study, in which 60 patients with fistula-in-ano were included on the basis of a predefined inclusion and exclusion criteria. MR imaging of patients was done by 1.5 T MRI machine. Before MR imaging normal saline was injected in the fistulous tract from secondary/external opening, that is, opening around perianal area. Three plane images were obtained in all the cases. T1W, T2W, and STIR image sequences were obtained parallel to pelvic diaphragm. Coronal cuts were imaged parallel to anal canal. FAT suppressed T1W and T2W images in all cases. Type and grade of fistula were determined in all the cases. P < 0.05 was taken as statistically significant. Results: Out of total 60 patients, there were 46 (76.66%) males and 14 (23.33%) were females with a M:F ratio of 1:0.30. The mean age of male and female patients was found to be 41.93±8.96 years and 44.04±7.46 years, respectively. The most common type of fistula was found to be trans-sphincteric fistula which was seen in 31 (51.6%) cases followed by intersphencteric fistula 22 (36.6%). Extrasphincteric and suprasphincteric fistulae were relatively uncommon and were seen in 4 (6.66%) and 3 (5%) cases, respectively. MRI was accurate in diagnosis of the tract with position of internal opening and any abscess cavity or secondary tract in 23 patients. Therefore, the diagnostic accuracy of MRI was found to be 95.4%. Conclusion: MRI is an excellent tool in assessment of perianal fistula. It not only helps in precisely locating fistulous tract but also can demonstrate relationship between the fistulous tract and sphincter muscles. Moreover, it can very well demonstrate transmural inflammation, secondary tracts/ramifications, and abscesses which cannot be assessed by conventional fistulograms.

scholarly journals A Video-Assisted Anal Fistula Treatment (VAAFT): A New Minimally Invasive Treatment Option for Fistula in Ano

2021 ◽  
pp. 135-139
Author(s):  
Nawaz Ali Dal ◽  
Arshad Hussain Abro ◽  
Muhammad Anwar Memon ◽  
Ahmer Akbar Memon ◽  
Muhammad Qasim Mallah ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Anal Fistula ◽  
Treatment Option ◽  
Complete Healing ◽  
Minimally Invasive Treatment ◽  
General Surgeon ◽  
Invasive Treatment ◽  
Fistula In Ano ◽  
Video Assisted ◽  
Fistula Treatment

Objective: To determine the outcome of video-assisted anal fistula treatment (VAAFT): A new minimally invasive treatment option for fistula in ano. Study Design: This is an observational study. Setting: Study carried out at General Surgery department, Liaquat University of Medical and Health Sciences Jamshoro, form January 2020 to June 2020. Material & Method: Inclusion criteria for this study were patients aged 18-60 years visiting the outpatient department with primary/recurrent fistula having symptoms. Among these individuals having anal fistula due to secondary causes like IBD, tuberculosis or any malignancy were not included in the study. VAAFT was performed by experience general surgeon and post-operative follow up was done till 1 years. Results: A total of 68 patients with fistula in ano were selected for video assisted anal fistula treatment (VAAFT) in our setup. It included 67.6% (n=46) males and 32.3% (n=22) females who agreed for the procedure. The mean age of patients were found to be 43+13 years. Post-operatively complete healing was observed in 75% (n=51) patients and 14.7% patients had persistent fistula after the procedure.  Conclusion: VAAFT is a minimally invasive surgical intervention implied to treat primary and recurrent anal fistulas, having lesser rates of recurrence and few post-operative complications. It should be implied over large scales for treatment of primary and recurrent anal fistula as it  carries the lowest rate of anal incontinence.

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