Prospective Analysis of 48 Consecutive Cases of VAAFT
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Prospective Analysis of 48 Consecutive Cases of VAAFT. Dr.Manoharan Nandakishore General and Laproscopic Surgeon Apollo Hospitals,Chennai. CONFLICT OF INTEREST. NONE. AIM. To study the safety, efficacy and patient comfort factor in the treatment of fistula in ano with VAAFT.

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Dr.Manoharan Nandakishore General and Laproscopic Surgeon Apollo Hospitals,Chennai

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Dr manoharan nandakishore general and laproscopic surgeon apollo hospitals chennai

Prospective Analysis of 48 Consecutive Cases of VAAFT

  • Dr.Manoharan Nandakishore

  • General and Laproscopic Surgeon

  • Apollo Hospitals,Chennai


Conflict of interest

CONFLICT OF INTEREST

NONE


Dr manoharan nandakishore general and laproscopic surgeon apollo hospitals chennai

AIM

To study the safety, efficacy and patient comfort factor in the treatment of fistula in ano with VAAFT.


Materials and methods

MATERIALS AND METHODS

This was a prospective study from August 2011 to February 2012 involving 48 patients, who had presented with fistula in ano.


Materials and methods1

MATERIALS AND METHODS

  • 9 patients – Low anal fistula

  • 16 patients – Intersphincteric fistula

  • 23 patients – Transsphincteric fistula


Recurrent fistula

RECURRENT FISTULA

6 of 16 Intersphincteric fistula

4 of 23 Transsphincteric fistula


Specific investigation

SPECIFIC INVESTIGATION

MR fistulogram

For all intersphinteric and transsphinteric cases and two cases of low anal fistula.


Anaesthesia

ANAESTHESIA

  • General Anaesthesia – 11 patients

  • Spinal Anaesthesia – 37 patients


Closure of internal opening

CLOSURE OF INTERNAL OPENING

32 patients

  • 12 patients - Mucosal flap – 8 patients had glue reinforcement

  • 20 patients – Stapler + glue reinforcement


Pain score

PAIN SCORE

Score 1 - 11 patients

Score 2 - 29 patients

Score 3 - 8 patients (GA)


Dr manoharan nandakishore general and laproscopic surgeon apollo hospitals chennai

PRE OPERATIVE


Dr manoharan nandakishore general and laproscopic surgeon apollo hospitals chennai

POST OPERATIVE


Length of hospital stay

LENGTH OF HOSPITAL STAY

  • 26 patients – Day care

  • 22 patients – 24 hours


Dr manoharan nandakishore general and laproscopic surgeon apollo hospitals chennai

3 MONTHS POST OPERATIVE


Recurrence

RECURRENCE


Recurrence1

RECURRENCE

Total 7

Low anal – 1

Intersphincteric -4 (2)

Transsphincteric – 2(2)


Return to normalcy

RETURN TO NORMALCY

100 % in 48 hours


Sphinter incontinence

SPHINTER INCONTINENCE

NONE


Conclusion

CONCLUSION

  • Safe

  • Effective

  • Low morbidity

  • Less Post operative pain

  • Better convalescence

  • Intact sphincter control

  • Less mutilating


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