Our Summary

This research paper discusses a new surgical treatment for complex anal fistula (an abnormal connection between the anal canal and the skin near the anus) called video-assisted anal fistula treatment (VAAFT). The researchers used this method on 52 patients and found it to be successful in all cases. The surgery took around 55 minutes on average and did not lead to any issues with bowel control. The main complications were three cases of sepsis (infection) and three cases of bleeding. Overall, 84.6% of patients completely healed without the condition returning after 9 months. The patients also showed a significant improvement in their quality of life related to their gastrointestinal health. The researchers concluded that VAAFT is a safe, less invasive option for treating complex anal fistula, while also preserving the function of the anal sphincter (the muscle that controls the release of stool).

FAQs

  1. What is video-assisted anal fistula treatment (VAAFT) and how does it work?
  2. What were the success rates and complications associated with the VAAFT method described in the research paper?
  3. How did the VAAFT surgery impact the patients’ quality of life and gastrointestinal health?

Doctor’s Tip

One helpful tip a doctor might give a patient about anal fistula surgery is to ensure they follow post-operative care instructions carefully, such as keeping the area clean and dry, taking prescribed medications, and attending follow-up appointments. It is also important to avoid straining during bowel movements and to eat a high-fiber diet to prevent constipation, which can aggravate the surgical site. Additionally, patients should be aware of any signs of infection, such as increased pain, redness, swelling, or discharge, and contact their healthcare provider immediately if they experience any of these symptoms.

Suitable For

Patients who are typically recommended for anal fistula surgery are those with complex anal fistulas that have not responded to other treatments such as antibiotics, drainage, or seton placement. These patients may experience symptoms such as recurrent infections, abscesses, pain, and discharge. Additionally, patients with anal fistulas that are causing significant discomfort or affecting their quality of life may also be recommended for surgery. It is important for patients to discuss their symptoms and treatment options with a healthcare provider to determine if surgery is the best course of action for their specific situation.

Timeline

Before anal fistula surgery:

  1. Patient experiences symptoms such as pain, swelling, discharge, and recurrent infections in the anal area.
  2. Patient consults with a healthcare provider who performs a physical examination and may order diagnostic tests such as an MRI or ultrasound to confirm the presence of an anal fistula.
  3. Treatment options such as antibiotics, drainage of abscesses, or seton placement may be attempted to manage symptoms before considering surgical intervention.
  4. Patient and healthcare provider discuss the risks and benefits of surgery, and a surgical plan is developed.

After anal fistula surgery:

  1. Patient undergoes VAAFT surgery, which involves using a video-assisted technique to identify and treat the fistula tract.
  2. Surgery typically lasts around 55 minutes and is performed under general anesthesia.
  3. Patient may experience mild pain and discomfort in the days following surgery, which can be managed with pain medication.
  4. Patient is advised to follow a specific diet and hygiene regimen to aid in healing and prevent infection.
  5. Follow-up appointments are scheduled to monitor healing progress and address any concerns or complications.
  6. After 9 months, the majority of patients show complete healing and improvement in quality of life related to gastrointestinal health.
  7. Patients may be advised to make lifestyle changes to prevent recurrence of anal fistula in the future.

What to Ask Your Doctor

  1. What is an anal fistula and why do I need surgery to treat it?
  2. What are the risks and potential complications associated with anal fistula surgery?
  3. How long will the surgery take and what is the recovery process like?
  4. Will I need to stay in the hospital overnight after the surgery?
  5. Will I experience any pain or discomfort after the surgery, and how can it be managed?
  6. Will I need to make any changes to my diet or lifestyle after the surgery?
  7. How likely is it that the anal fistula will return after surgery?
  8. Are there any alternative treatment options to consider?
  9. How will this surgery affect my bowel control and overall quality of life?
  10. How many times have you performed this type of surgery and what is your success rate?

Reference

Authors: Jiang HH, Liu HL, Li Z, Xiao YH, Li AJ, Chang Y, Zhang Y, Lv L, Lin MB. Journal: Med Sci Monit. 2017 Apr 30;23:2065-2071. doi: 10.12659/msm.904055. PMID: 28456815