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30 April 2017 : Clinical Research

Video-Assisted Anal Fistula Treatment (VAAFT) for Complex Anal Fistula: A Preliminary Evaluation in China

Hui-hong Jiang1BCDEF, Hai-long Liu1CDEF, Zhen Li1CDF, Yi-hua Xiao1ABD, A-jian Li1BCF, Yi Chang1BCF, Yong Zhang1ABD, Liang Lv1AEF, Mou-bin Lin12AEG*

DOI: 10.12659/MSM.904055

Med Sci Monit 2017; 23:2065-2071

Abstract

BACKGROUND: Although many attempts have been made to advance the treatment of complex anal fistula, it continues to be a difficult surgical problem. This study aimed to describe the novel technique of video-assisted anal fistula treatment (VAAFT) and our preliminary experiences using VAAFT with patients with complex anal fistula.

MATERIAL AND METHODS: From May 2015 to May 2016, 52 patients with complex anal fistula were treated with VAAFT at Yangpu Hospital of Tongji University School of Medicine, and the clinical data of these patients were reviewed.

RESULTS: VAAFT was performed successfully in all 52 patients. The median operation time was 55 minutes. Internal openings were identified in all cases. 50 cases were closed with sutures, and 2 were closed with staplers. Complications included perianal sepsis in 3 cases and bleeding in another 3 cases. Complete healing without recurrence was achieved in 44 patients (84.6%) after 9 months of follow-up. No fecal incontinence was observed. Furthermore, a significant improvement in Gastrointestinal Quality of Life Index (GIQLI) score was observed from preoperative baseline (mean, 85.5) to 3-month follow-up (mean, 105.4; p<0.001), and this increase was maintained at 9-months follow-up (mean, 109.6; p<0.001).

CONCLUSIONS: VAAFT is a safe and minimally invasive technique for treating complex anal fistula with preservation of anal sphincter function.

Keywords: Rectal Fistula, Surgical Procedures, Minimally Invasive, Video-Assisted Surgery

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Medical Science Monitor eISSN: 1643-3750