Our Summary
This research paper is about a study that compared two methods of treating a medical condition called high anal fistula: Video-assisted anal fistula treatment (VAAFT) and fistulectomy and sphincter repair (FSR). The outcomes they looked at were how likely the condition was to come back (recurrence), muscle function in the anus (anal manometry), quality of life, and ability to control bowel movements (faecal continence).
The researchers had to stop the study early because both treatments had high recurrence rates, meaning the condition came back in a lot of patients. They found that FSR had a lower recurrence rate than VAAFT. But, the length of the fistula (the abnormal connection that forms in the body) was found to be a risk factor and was associated with recurrence.
The study also found differences in the secondary outcomes. Quality of life was better with FSR, while anal manometry was better with VAAFT. Both treatments showed a significant improvement in faecal continence.
In simple terms, the study found that for treating high anal fistula, FSR had a lower risk of the condition returning than VAAFT, but both treatments had higher recurrence rates than expected. The study also found differences in quality of life, muscle function in the anus, and ability to control bowel movements between the two treatments.
FAQs
- What are the two methods of treating high anal fistula that were compared in this study?
- Which treatment method had a lower recurrence rate of the condition - VAAFT or FSR?
- Were there differences in quality of life and ability to control bowel movements between the two treatments?
Doctor’s Tip
A helpful tip a doctor might give a patient about anal fistula surgery is to follow post-operative care instructions closely, including proper wound care, avoiding strenuous activity, and taking prescribed medications as directed. It’s also important to attend all follow-up appointments to monitor healing and address any concerns promptly. Lastly, maintaining good hygiene in the anal area can help prevent infection and promote healing.
Suitable For
Typically, patients who are recommended for anal fistula surgery are those with high anal fistulas that have not responded to other forms of treatment such as medications or drainage procedures. Patients with recurrent or complex fistulas, as well as those experiencing symptoms such as pain, swelling, discharge, and difficulty controlling bowel movements, may also be candidates for surgery. Additionally, patients with underlying conditions such as Crohn’s disease or immunocompromised individuals may be recommended for surgery to prevent complications. It is important for patients to consult with their healthcare provider to determine the most appropriate treatment plan for their individual case.
Timeline
Before anal fistula surgery, a patient may experience symptoms such as pain, swelling, discharge, and difficulty controlling bowel movements. They may undergo tests such as physical examination, ultrasound, MRI, or CT scan to diagnose the condition and determine the best course of treatment.
After anal fistula surgery, the patient may experience some pain, swelling, and discomfort in the area. They will need to follow post-operative instructions from their surgeon, such as taking pain medication, keeping the area clean, and avoiding strenuous activities. The healing process can take several weeks, and the patient may need to follow up with their surgeon for additional care.
Overall, the timeline before and after anal fistula surgery involves diagnosis, treatment decision-making, surgery, post-operative care, and recovery. It is important for patients to communicate with their healthcare providers throughout this process to ensure the best possible outcome.
What to Ask Your Doctor
Some questions a patient should ask their doctor about anal fistula surgery include:
- What are the potential risks and complications associated with anal fistula surgery?
- How long is the recovery process and what can I expect during the recovery period?
- What is the success rate of the surgery in terms of preventing the fistula from recurring?
- How will the surgery impact my ability to control bowel movements and maintain faecal continence?
- Will I need to make any changes to my diet or lifestyle after the surgery?
- Are there any alternative treatments or procedures available for my condition?
- How experienced is the surgeon in performing anal fistula surgeries, and what is their success rate?
- Will I need any additional follow-up appointments or procedures after the surgery?
- How long does the surgery typically take, and will I need to stay in the hospital overnight?
- What type of anesthesia will be used during the surgery, and are there any specific pre-operative instructions I need to follow?
Reference
Authors: Sørensen KM, Möller S, Qvist N. Journal: BJS Open. 2021 Sep 6;5(5):zrab097. doi: 10.1093/bjsopen/zrab097. PMID: 34611700