Dr.Manoharan Nandakishore
General and Laproscopic SurgeonApollo Hospitals,Chennai
Prospective Analysis of 48 Consecutive Cases of VAAFT
CONFLICT OF INTEREST
NONE
AIM
To study the safety, efficacy and patient comfort factor in the treatment of fistula in ano with VAAFT.
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 METHODS
9 patients – Low anal fistula
16 patients – Intersphincteric fistula
23 patients – Transsphincteric fistula
RECURRENT FISTULA
6 of 16 Intersphincteric fistula
4 of 23 Transsphincteric fistula
SPECIFIC INVESTIGATION
MR fistulogram For all intersphinteric and transsphinteric cases and two cases of low anal fistula.
ANAESTHESIA
General Anaesthesia – 11 patients
Spinal Anaesthesia – 37 patients
CLOSURE OF INTERNAL OPENING
32 patients
12 patients - Mucosal flap – 8 patients had
glue reinforcement
20 patients – Stapler + glue reinforcement
PAIN SCORE
Score 1 - 11 patients Score 2 - 29 patients
Score 3 - 8 patients (GA)
PRE OPERATIVE
POST OPERATIVE
LENGTH OF HOSPITAL STAY
26 patients – Day care
22 patients – 24 hours
3 MONTHS POST OPERATIVE
RECURRENCE
RECURRENCE
Total 7
Low anal – 1 Intersphincteric -4 (2)Transsphincteric – 2(2)
RETURN TO NORMALCY
100 % in 48 hours
SPHINTER INCONTINENCE
NONE
CONCLUSION
Safe
Effective
Low morbidity
Less Post operative pain
Better convalescence
Intact sphincter control
Less mutilating
