Our Summary

This research paper discusses a study about the long-term effectiveness of video-assisted anal fistula treatment (VAAFT). Anal fistula is a painful condition where an abnormal tunnel develops between the skin near the anus and the end of the bowel. VAAFT is a method of treating this condition that does not damage the anal sphincter muscles.

The researchers looked at the medical records of 106 adult patients who had undergone VAAFT and were followed up for at least 2 years after their surgery. They found that the treatment failed in 13% of patients, meaning the fistula did not fully heal in the first 6 months. They also found that the recurrence rate of the fistula, or the condition coming back after initially healing, ranged from 29% after 1 year to 63% after 5 years.

The researchers found that the chances of the fistula coming back were higher in patients who had multiple fistula openings, a specific type of fistula that extends above the sphincter muscles, were younger, had previous surgery, and had a more complex fistula tract.

The study concluded that VAAFT is a safe method of treating anal fistula that initially has a high success rate. However, this success rate decreases over time and is lower in more complex cases.

FAQs

  1. What is video-assisted anal fistula treatment (VAAFT) and how does it work?
  2. What are the long-term effectiveness rates of VAAFT according to the study?
  3. What factors were found to increase the chances of fistula recurrence after VAAFT?

Doctor’s Tip

A doctor may advise a patient undergoing anal fistula surgery to make sure to follow all post-operative care instructions, including keeping the area clean and dry, avoiding strenuous physical activity, and taking any prescribed medications as directed. They may also recommend regular follow-up appointments to monitor healing progress and address any concerns or complications that may arise. It is important for patients to communicate openly with their healthcare provider throughout the recovery process to ensure the best possible outcome.

Suitable For

Patients who are typically recommended anal fistula surgery are those who have a painful anal fistula that is causing discomfort and affecting their quality of life. This includes patients who have multiple fistula openings, a complex fistula tract, previous failed surgeries, and are younger in age. These patients are more likely to benefit from surgery to treat their anal fistula and prevent recurrence of the condition.

Timeline

Before anal fistula surgery:

  1. Patient experiences symptoms such as pain, swelling, and drainage near the anus.
  2. Patient undergoes a physical examination and possibly imaging tests to diagnose the anal fistula.
  3. Patient may be prescribed antibiotics or other medications to manage symptoms before surgery.
  4. Patient discusses treatment options with their healthcare provider, including the possibility of anal fistula surgery.

After anal fistula surgery:

  1. Patient undergoes VAAFT surgery to treat the anal fistula without damaging the anal sphincter muscles.
  2. Patient may experience discomfort, swelling, and drainage in the days following surgery.
  3. Patient follows post-operative care instructions, including wound care and taking prescribed medications.
  4. Patient attends follow-up appointments to monitor healing and address any complications.
  5. Patient may experience recurrence of the anal fistula over time, especially in more complex cases.
  6. Patient may require additional treatments or surgeries if the anal fistula does not fully heal or recurs.

What to Ask Your Doctor

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

  1. What are the potential risks and complications associated with VAAFT surgery?
  2. What is the success rate of VAAFT in treating anal fistulas?
  3. How long is the recovery period after VAAFT surgery?
  4. What can I expect in terms of pain and discomfort after the surgery?
  5. Will I need to make any changes to my diet or lifestyle after the surgery?
  6. How often will I need follow-up appointments after the surgery?
  7. What is the likelihood of the fistula coming back after the surgery?
  8. Are there any alternative treatment options for anal fistulas that I should consider?
  9. How experienced are you in performing VAAFT surgery?
  10. Can you provide me with any patient testimonials or success stories from previous VAAFT surgeries you have performed?

Reference

Authors: La Torre M, Goglia M, Micarelli A, Fiori E, D’Andrea V, Grossi U, Tierno SM, Tomassini F, Gallo G. Journal: Colorectal Dis. 2023 Oct;25(10):2017-2023. doi: 10.1111/codi.16732. Epub 2023 Sep 1. PMID: 37658596