Our Summary

This research paper analyzes the effectiveness and safety of Video-Assisted Anal Fistula Treatment (VAAFT) in treating complex anorectal fistulas, which are abnormal connections between the anal canal and the skin near the anus. The researchers reviewed 14 trials involving 1201 patients and found that VAAFT has a success rate of 83%, with a 16% chance of the condition recurring and an 11% rate of postoperative complications. The method of closing the internal opening of the fistula affected the recurrence rates, with suturing and the use of advancement flaps being slightly more successful than using staplers. The study also found that patients stayed in the hospital for an average of 3.15 days after the procedure. The researchers concluded that VAAFT could be a good alternative to other treatments for complex anorectal fistulas, as it can reduce the long-term effects of anal incontinence (loss of bowel control) and surgical complications, and promote faster healing and rehabilitation.

FAQs

  1. What is the success rate of Video-Assisted Anal Fistula Treatment (VAAFT) in treating complex anorectal fistulas?
  2. How does the method of closing the internal opening of the fistula affect the recurrence rates?
  3. How long do patients typically stay in the hospital after undergoing VAAFT?

Doctor’s Tip

A doctor may advise a patient undergoing anal fistula surgery to follow post-operative care instructions carefully, including keeping the surgical site clean and dry, avoiding strenuous activities, and taking prescribed medications as directed. They may also recommend a high-fiber diet to prevent constipation, which can put strain on the surgical site. Additionally, the doctor may suggest regular follow-up appointments to monitor healing progress and address any concerns or complications that may arise.

Suitable For

Patients who are typically recommended anal fistula surgery are those with complex anorectal fistulas that have not responded to conservative treatments such as antibiotics, drainage, and medication. These patients may experience symptoms such as persistent pain, swelling, discharge, and recurrent infections. Surgery is typically recommended for patients with high-risk fistulas, such as those that are deep, complex, or have multiple tracts. Additionally, patients with underlying conditions such as Crohn’s disease or immunodeficiency may also be candidates for anal fistula surgery. Ultimately, the decision to undergo surgery will depend on the individual patient’s symptoms, medical history, and overall health status.

Timeline

Before anal fistula surgery, a patient may experience symptoms such as pain, swelling, discharge, and recurrent infections around the anus. They may also undergo diagnostic tests such as physical examination, MRI, or fistulography to determine the extent and location of the fistula.

After anal fistula surgery, the patient may experience some pain, swelling, and discomfort in the anal region. They will be given pain medication and antibiotics to prevent infection. The patient will need to follow a strict postoperative care routine, which may include keeping the surgical area clean, taking sitz baths, and avoiding certain activities such as heavy lifting or strenuous exercise. Follow-up appointments with the surgeon will be scheduled to monitor healing and address any concerns. In some cases, additional treatments or procedures may be required to address complications or recurrent fistulas.

What to Ask Your Doctor

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

  • What are the risks and benefits of VAAFT compared to other surgical treatments for anal fistulas?
  • What is the success rate of VAAFT in treating complex anorectal fistulas?
  • What is the likelihood of the fistula recurring after VAAFT surgery?
  • What are the potential postoperative complications of VAAFT?
  • How long is the typical recovery time after VAAFT surgery?
  • Will I need to stay in the hospital after the procedure, and if so, for how long?
  • What can I expect in terms of pain management and wound care following VAAFT surgery?
  • Are there any long-term effects or considerations to keep in mind after undergoing VAAFT surgery?
  • What is the experience and success rate of the surgeon performing the VAAFT procedure?
  • Are there any specific lifestyle changes or precautions I should take before and after VAAFT surgery to optimize healing and prevent complications?

Reference

Authors: Tian Z, Li YL, Nan SJ, Xiu WC, Wang YQ. Journal: Tech Coloproctol. 2022 Oct;26(10):783-795. doi: 10.1007/s10151-022-02614-z. Epub 2022 Mar 28. PMID: 35347492