VAAFT versus fistulectomy in the management of anorectal fistulae: a comparative study?

Mahidhar Reddy Venkatapuram; Sreeram Sateesh

doi:10.18203/2349-2902.isj20175153

Authors

Mahidhar Reddy Venkatapuram Department of General Surgery, Narayana Medical College and Hospital, Nellore, Andhra Pradesh, India
Sreeram Sateesh Department of General Surgery, Narayana Medical College and Hospital, Nellore, Andhra Pradesh, India

DOI:

https://doi.org/10.18203/2349-2902.isj20175153

Keywords:

Anorectal fistulae, Fistula-in-ano, Fistulectomy, Video assisted anal fistula treatment (VAAFT), Visual analogue scale (VAS)

Abstract

Background: Among the perianal diseases Fistula in ano is a very common condition bringing lot of discomfort to the patient with a high rate of recurrence as well. Conventionally fistulectomy has been the treatment of choice for fistula-in-ano. But the procedure is associated with lot of recurrence, morbidity and sphincter incontinence. Among several recent procedures VAAFT-video assisted anal fistula treatment is gaining popularity. So, we conducted this study to know the effectiveness of VAAFT over conventional fistulectomy.

Methods: This prospective comparative study was undertaken to compare VAAFT and fistulectomy in the management of fistula-in-ano. A one-year study was carried out on 50 patients from mid-2015 to 2016. A visual analogue scale (VAS) was used to assess pain in the postoperative period. All patients were observed for one-year period for any recurrence of disease. Results were statistically analysed by SPSS 15.0 software.

Results: two groups were formed among the 50 patients selected for study. There was male preponderance in both the groups. majority of patients belonged to 31-40 years of age group. Majority of the patients had low anal fistulae followed by patients with high anal fistulae and anorectal fistulae in that order. There was recurrence of disease in 12% of people operated by fistulectomy whereas it was only 1% in group who underwent VAAFT.

Conclusions: VAAFT procedure offered significantly less recurrence rates in comparison with fistulectomy. There was less postoperative pain and nil complications after surgery. Patient satisfaction was high. Our study concluded VAAFT as a safe and effective procedure alternative to conventional fistulectomy.

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