Our Summary

This research paper discusses a study conducted on children who had a condition called anal fistula and perianal abscess, which are problems related to the anus and rectum. The researchers used a surgical procedure called VAAFT (video-assisted anal fistula treatment) and applied a dressing made with ozonide oil after the surgery. They studied all patients who underwent this procedure between August 2018 and May 2023.

They found that the procedure was performed on 30 children, with their ages ranging from about 2 to 14 years old. The majority of these cases (about 87%) were idiopathic, meaning the cause was unknown. A small percentage were caused by other factors like a previous surgical procedure or Crohn’s disease, a type of inflammatory bowel disease.

The surgery took about 23 minutes on average, and the children were kept in the hospital for about one day. After the surgery, the ozonide oil dressing was applied twice daily for 5 weeks, and the average healing time was about a month.

Over a follow-up period of up to 5 years, only 10% of the patients experienced a recurrence of the condition, but they were successfully treated again with the same procedure and did not have any further issues. Importantly, no children suffered from fecal incontinence or soiling, which can be a concern with this type of surgery.

The researchers concluded that VAAFT is a safe and effective treatment for children with these conditions. However, they suggest that more comparative studies are needed to further confirm these findings.

FAQs

  1. What is VAAFT and how is it used in the treatment of anal fistula and perianal abscess in children?
  2. What were the results of the study on the use of VAAFT and ozonide oil dressing in treating children with anal fistula and perianal abscess?
  3. What is the recovery process like for children who undergo VAAFT for the treatment of anal fistula and perianal abscess?

Doctor’s Tip

A helpful tip a doctor might give a patient about anal fistula surgery is to follow post-operative care instructions carefully, including keeping the surgical area clean and dry, taking prescribed medications as directed, and attending follow-up appointments to monitor healing progress. It is also important to maintain good hygiene practices, such as regular bathing and wearing loose-fitting clothing, to prevent infection and promote healing. If any unusual symptoms or complications arise, it is important to contact your healthcare provider immediately for further evaluation and treatment.

Suitable For

Typically, patients who are recommended anal fistula surgery are those who have not responded to conservative treatments such as antibiotics, sitz baths, and drainage of abscesses. Patients with complex or recurrent fistulas, as well as those with underlying conditions such as Crohn’s disease or diabetes, may also be candidates for surgery.

Anal fistula surgery may be recommended for patients who experience symptoms such as persistent drainage, pain, swelling, or recurrent infections in the anal or rectal area. Surgery may also be necessary if the fistula is causing complications such as abscess formation, fistula tract extension, or difficulty with bowel movements.

Overall, the decision to undergo anal fistula surgery is typically made on a case-by-case basis, taking into consideration the individual patient’s symptoms, medical history, and overall health. It is important for patients to discuss the risks and benefits of surgery with their healthcare provider to determine the most appropriate treatment plan for their specific situation.

Timeline

Before anal fistula surgery:

  1. Patient experiences symptoms such as pain, swelling, discharge, and discomfort around the anus.
  2. Patient undergoes a physical examination and possibly imaging tests to diagnose the anal fistula.
  3. Treatment options, including surgery, are discussed with the patient by the healthcare provider.
  4. Patient may undergo pre-operative tests and preparations before the surgery.

After anal fistula surgery:

  1. Patient undergoes the VAAFT procedure, which involves using a video-assisted technique to treat the anal fistula.
  2. Ozonide oil dressing is applied post-surgery to aid in healing.
  3. Patient is kept in the hospital for monitoring and discharged within a day in most cases.
  4. Patient continues to apply the ozonide oil dressing twice daily for 5 weeks.
  5. Patient experiences healing, with the average healing time being about a month.
  6. Follow-up appointments are scheduled to monitor the patient’s progress and check for any recurrence of the condition.
  7. In the long term, only a small percentage of patients experience a recurrence, which can be successfully treated with the same procedure.

Overall, the anal fistula surgery, specifically using the VAAFT technique and ozonide oil dressing, has shown to be a safe and effective treatment option for children with this condition, with minimal risk of complications like fecal incontinence.

What to Ask Your Doctor

Some questions a patient should ask their doctor about anal fistula surgery include:

  1. What is the success rate of VAAFT surgery for anal fistulas in children?
  2. What are the potential risks and complications associated with this surgery?
  3. How long is the recovery time after VAAFT surgery?
  4. Will I need to follow a special diet or make any lifestyle changes after the surgery?
  5. How often will I need follow-up appointments after the procedure?
  6. Are there any long-term effects or considerations I should be aware of following this surgery?
  7. Will I need any additional treatments or procedures in the future for my anal fistula?
  8. What can I do to reduce the risk of recurrence of the anal fistula after surgery?
  9. How experienced are you in performing VAAFT surgery for anal fistulas in children?
  10. Are there any alternative treatment options available for my condition?

Reference

Authors: Esposito C, Autorino G, Cerulo M, Del Conte F, Coppola V, Esposito G, Chiodi A, Di Mento C, Bagnara V, Escolino M. Journal: Surg Endosc. 2024 Apr;38(4):2273-2279. doi: 10.1007/s00464-024-10759-1. Epub 2024 Mar 5. PMID: 38443498