Video-assisted anal fistula treatment in the management of fistula-in-ano: A 3-year experience

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.

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

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2021/61 ◽

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

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

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2021/v33i29a31571 ◽

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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