Evaluation of Effectiveness and Safety of Video Assisted Anal Fistula Treatment
Keywords:
Anal fistula, Video-Assisted Anal Fistula Treatment (VAAFT), FistuloscopeAbstract
Background: Although anal fistulae are common and well-studied, complex forms remain challenging to treat, requiring a careful balance between preventing recurrence and preserving continence—making minimally invasive techniques like video-assisted anal fistula treatment (VAAFT) a promising option due to their sphincter-sparing approach and ability to accurately identify internal openings and secondary tracts.
Aim: The primary goal of this prospective pilot study is to evaluate the safety and benefits of using the new device “Fistuloscope” for the treatment of anal fistula, as Video Assisted Anal Fistula Treatment (VAAFT) is a novel technique that will be used during this study to treat anal fistula.
Subjects and methods: This prospective pilot study included 20 patients with fistula in ano who were presented to the Department of General Surgery, Faculty of Medicine, Beni-Suef University Hospital, with the study conducted from March 2018 until August 2020 (two years and five months).
Result: The mean age of males was 42.4 years and the mean age of females was 38.2 years. The internal fistula opening was closed by advancement flap in 6 patients (30%) using vicryl 2/0, by stapler in 6 patients (30%) and by primary interrupted sutures using vicryl 2/0 in 8 patients (40%).
Conclusion: VAAFT is a safe and minimally invasive procedure for the treatment of complex anal fistula while preserving anal sphincter function. Neither this study nor other studies mentioned that it was damage to the anal sphincter or fecal incontinence, accordingly- we can consider VAAFT procedure as: Sphincter-Saving Fistula Surgery.
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References
Kim Y and Park YJ. Three- dimensional endoanal ultrasonographic assessment of anal fistula with and without H2O2 enhancement. World J Gastroenterology. 2009; 15:4810-4815.
Westerterp M, Volkers NA, Poolman RW and van Tets WF (2003): Anal fistulotomy between Skylla and Charybdis. Colorectal Dis; 5: 549-551.
Visscher AP, Schuur D, Roos R, Van der Mijnsbrugge GJ, Meijerink WJ and Felt-Bersma RJ (2015): Long-term follow-up after surgery for simple and complex cryptoglandular fistulas: fecal incontinence and impact on quality of life. Dis Colon Rectum; 58: 533-539.
Limura E, Giordano P. Modern management of anal fistula. World Journal of Gastroenterology: WJG. 2015;21(1):12-19.
Meinero P, Mori L. Video-assisted anal fistula treatment (VAAFT): a novel sphincter-saving procedure for treating complex anal fistulas. Techniques in coloproctology. 2011;15(4):417-22.
Garcia-Aguilar J, Belmonte C, Wong WD, Goldberg SM, Madoff RD. Anal fistula surgery. Diseases of the colon & rectum. 1996; 39(7):723-9.
Schwandner O. Video-assisted anal fistula treatment (VAAFT) combined with advancement flap repair in Crohn’s disease. Techniques in coloproctology. 2013;17(2):221-5.
Haefeli M, Elfering A. Pain assessment. Eur Spine J. 2006;15 Suppl 1(Suppl 1):S17-S24.
Klimek L, Bergmann KC, Biedermann T, Bousquet J, Hellings P, Jung K, Merk H, Olze H, Schlenter W, Stock P, Ring J. Visual analogue scales (VAS): Measuring instruments for the documentation of symptoms and therapy monitoring in cases of allergic rhinitis in everyday health care. Allergo journal international. 2017 Feb 1;26(1):16-24.
Zanotti C, Martinez-Puente C, Pascual I, Pascual M, Herreros D, García-Olmo D. An assessment of the incidence of fistula-in-ano in four countries of the European Union. Int J Colorectal Dis. 2007;22(12):1459-62.
Parks AG, Gordon PH, Hardcastle JE. A classification of fistula-in-ano. Br J Surg 1976; 63:1–12.
Pescatori M, Ayabaca SM, Cafaro D, Iannello A, Magrini S. Marsupialization of fistulotomy and fistulectomy wounds improves healing and decreases bleeding: a randomized controlled trial. Colorectal Disease. 2006;8(1):11-4.
Atkin GK, Martins J, Tozer P, Ranchod P, Phillips RK. For many high anal fistulas, lay open is still a good option. Techniques in coloproctology. 2011; 15(2):143-50.
Chowbey PK, Khullar R, Sharma A, Soni V, Najma K, Baijal M. Minimally invasive anal fistula treatment (MAFT)—an appraisal of early results in 416 patients. Indian Journal of Surgery. 2015; 77(2): 716-21.
Brozovich MD ME. Abstracts from the XXVI Biennial Congress of the International Society of University Colon & Rectal Surgeons, Cape Town, South Africa, September 4-7 2014. World Journal of Colorectal Surgery. 2014;4(3):1-17.
Mendes CR, FERREIRA LS, Sapucaia RA, Lima MA, Araujo SE. Video-assisted anal fistula treatment: technical considerations and preliminary results of the first Brazilian experience. ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo). 2014; 27(1):77-81.
Giarratano G, Shalaby M, Toscana C, Sileri P. Video‐assisted anal fistula treatment for complex anal fistula: a long‐term follow‐up study. Colorectal Disease. 2020;22(8):939-44.
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