Our Summary

This research paper is about a new minimally invasive procedure called VAAFT (Video Assisted Anal Fistula Treatment) for treating anal fistulas - basically, abnormal connections between the skin and the inside of the anal canal. The study followed 84 patients who had this procedure to see how well it worked and if there were any recurring issues.

The study found that 97.6% of the participants were male, and the average time for the procedure was about 24 minutes. On a pain scale (VAS), the average score was 3.7 out of 10. The procedure was effective, with healing observed in about 83% of the cases and only 10% of patients experiencing a recurrence after one year. All patients maintained normal muscle function after the surgery.

In conclusion, this study provides evidence that VAAFT can be a successful treatment for anal fistulas, with a good rate of healing and low rate of recurrence. The findings are in line with other studies, but the authors suggest further research with larger sample sizes and longer follow-up times to confirm VAAFT’s effectiveness compared to other treatment options.

FAQs

  1. What is VAAFT and how does it treat anal fistula?
  2. What were the primary healing and recurrence rates observed in this study on VAAFT?
  3. How does the use of a fistuloscope in VAAFT provide an advantage over other treatment modalities for anal fistula?

Doctor’s Tip

One helpful tip a doctor might tell a patient about anal fistula surgery is to follow post-operative care instructions carefully to promote healing and reduce the risk of recurrence. This may include keeping the area clean, avoiding strenuous activities, and taking prescribed medications as directed. It is also important to attend follow-up appointments with your healthcare provider to monitor healing progress and address any concerns.

Suitable For

Patients who are typically recommended anal fistula surgery include those who have recurrent or complex fistulas that have not responded to other treatments such as antibiotics or fistulotomy. These patients may experience symptoms such as persistent pain, discharge, and recurrent abscess formation. Additionally, patients with underlying conditions such as Crohn’s disease or immunocompromised states may also be candidates for anal fistula surgery. It is important for patients to discuss their individual case with a healthcare provider to determine the best treatment approach for their specific situation.

Timeline

Before anal fistula surgery:

  • Patient experiences symptoms such as pain, swelling, discharge, and discomfort in the anal area.
  • Patient may undergo physical examination, imaging tests, and possibly a fistulogram to diagnose the fistula.
  • Patient may receive conservative treatment such as antibiotics, sitz baths, and dietary changes to manage symptoms.

After anal fistula surgery:

  • Patient undergoes VAAFT procedure, which involves real-time visualization of the fistula tract and internal opening using a fistuloscope.
  • The surgery typically lasts around 24 minutes with a mean pain score of 3.7.
  • Postoperatively, patients are monitored for primary healing and continence at 6 weeks, and recurrence at 1 year.
  • Healing is observed in 83.2% of patients, with a 10% recurrence rate at one year.
  • All patients had normal sphincteric function postoperatively.
  • Further studies with larger sample sizes and longer follow-up periods are needed to confirm the superiority of VAAFT over other treatment options for anal fistula.

What to Ask Your Doctor

  1. What is the success rate of VAAFT compared to other treatment options for anal fistulas?
  2. What are the potential risks and complications associated with VAAFT surgery?
  3. How long is the recovery period after VAAFT surgery?
  4. Will I experience any changes in bowel movements or fecal incontinence after the surgery?
  5. How long do the results of VAAFT surgery typically last before a recurrence may occur?
  6. What is the likelihood of needing additional treatments or surgeries in the future after VAAFT surgery?
  7. Are there any dietary or lifestyle changes I should make before or after VAAFT surgery to improve outcomes?
  8. How experienced are you in performing VAAFT surgeries, and what is your success rate with this procedure?
  9. Can you provide me with information about any support groups or resources for patients undergoing VAAFT surgery?
  10. Are there any alternative treatment options for anal fistulas that I should consider before proceeding with VAAFT surgery?

Reference

Authors: Khan MA, Ullah R, Kamran H, Zarin M. Journal: J Ayub Med Coll Abbottabad. 2022 Jan-Mar;34(1):8-11. doi: 10.55519/JAMC-01-8815. PMID: 35466618