Our Summary

This research paper is about a study that looked at the effectiveness and safety of a procedure called video-assisted anal fistula treatment (VAAFT) for people with a condition known as anorectal fistulas. This condition is basically an abnormal connection between the rectum and the skin near the anus.

The researchers gathered and analyzed data from previous studies done on this procedure. They looked at 10 different articles, which included information on 779 patients. They considered factors like the patients’ ages, the length of the surgery, how long the patients were followed up after the procedure, the ratio of men to women, and the ratio of complex to simple fistulas. They also looked at how often the surgeons were able to find the internal opening of the fistula, how often the fistula came back after the surgery, and how often there were complications after the surgery.

Their analysis showed that VAAFT is a pretty effective procedure. Surgeons were able to find the internal opening of the fistula 98% of the time. The fistula came back after the surgery in 24% of the cases, and there were complications in just 1% of the cases.

So, overall, the study concludes that VAAFT is a good option for treating anorectal fistulas. It’s effective and safe, with a high success rate and low risk of complications.

FAQs

  1. What is the recurrence rate after video-assisted anal fistula treatment (VAAFT)?
  2. How safe and effective is video-assisted anal fistula treatment (VAAFT) in treating anorectal fistulas?
  3. What is the complication rate following video-assisted anal fistula treatment (VAAFT)?

Doctor’s Tip

One helpful tip a doctor might give a patient about anal fistula surgery is to follow post-operative care instructions carefully to reduce the risk of complications and improve healing. This may include keeping the area clean, taking prescribed medications as directed, and avoiding activities that could strain the surgical site. It’s also important to attend all follow-up appointments with your doctor to monitor healing progress and address any concerns promptly.

Suitable For

Patients who are typically recommended for anal fistula surgery include those with recurrent or complex anal fistulas, those with symptoms such as pain, discharge, or swelling around the anus, and those who have not responded to non-surgical treatments such as antibiotics or drainage procedures. The study mentioned above found that VAAFT is effective and safe in the treatment of anorectal fistulas, with a low recurrence rate and low incidence of complications.

Timeline

Before anal fistula surgery:

  1. Patient experiences symptoms such as pain, swelling, discharge, and discomfort around the anal area.
  2. Patient consults with a healthcare provider who performs a physical examination and may order imaging tests to diagnose the anal fistula.
  3. Treatment options are discussed, including surgery as a potential solution to treat the anal fistula.

After anal fistula surgery:

  1. Patient undergoes video-assisted anal fistula treatment (VAAFT) which involves a minimally invasive procedure to treat the anal fistula.
  2. Average operation time is 60 minutes, and the patient is typically discharged the same day or within a few days post-surgery.
  3. Patient is advised on post-operative care, which may include pain management, wound care, and dietary restrictions.
  4. Patient follows up with the healthcare provider for monitoring and evaluation of the surgical site.
  5. Average follow-up time is 22 months, during which the recurrence rate and incidence of complications are assessed.
  6. Studies have shown that VAAFT has a weighted recurrence rate of 24% and a weighted complication rate of 1%, indicating that it is an effective and safe treatment option for anal fistulas.

What to Ask Your Doctor

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

  1. What is the success rate of anal fistula surgery, particularly the recurrence rate?
  2. What are the potential complications or risks associated with anal fistula surgery?
  3. What is the expected recovery time and post-operative care plan?
  4. Are there any alternative treatment options available for anal fistulas?
  5. How experienced is the surgeon in performing anal fistula surgery, and what is their success rate?
  6. Will I need any further procedures or treatments after the surgery?
  7. How will my symptoms be managed before and after the surgery?
  8. What can I expect in terms of pain management during and after the surgery?
  9. Are there any lifestyle changes or dietary modifications I should make before or after the surgery?
  10. What follow-up appointments will be necessary after the surgery?

Reference

Authors: Wang C, Huang T, Wang X. Journal: Minerva Gastroenterol (Torino). 2023 Dec;69(4):529-536. doi: 10.23736/S2724-5985.21.02925-9. PMID: 38197847