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