Video-assisted anal fistula treatment in the management of fistula-in-ano: A 3-year experience

• Main Authors: Hussein Oudah Al-Jasmawi, Alaa Bakir Raheem Al-Mhanaa, Mohammed Salih Al-Janabi
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2019-01-01
• Series: Medical Journal of Babylon
• Subjects: anal fistula; meinero fistuloscope; video-assisted anal fistula treatment
• Online Access: http://www.medjbabylon.org/article.asp?issn=1812-156X;year=2019;volume=16;issue=4;spage=267;epage=270;aulast=Al-Jasmawi
• ISSN: 1812-156X; 2312-6760

Background: Fistula-in-ano and especially the high and complicated type is still one of the difficult surgical problems to solve. The new promising technique, video-assisted anal fistula treatment (VAAFT) was done first by Professor P. Meinero in 2006. Objective: The objective of the study was to describe the technique and the encouraging result of VAAFT. Materials and Methods: Using Karl Storz Company fistuloscope, 200 patients with anal fistulas were treated in Babylon Private Hospital in Al Hilla (Center of Babylon Governorate). This was done in two phases: diagnostic phase including visualization of fistula tract and identification of internal opening, followed by the operative phase by cauterization, curettage of the tract, irrigation using 1% mannitol solution, and closure of the internal opening using no. 1 Vicryl (polyglactin). Results: From the 200 patients with anal fistulas, 40 patients (20%) had undergone classical fistula surgery. No major complications were recorded. Early and late postoperative pain and discomfort were mild. The cases followed up at 6 weeks and 3 months postoperatively. Primary healing rate was 70% at 12 weeks and 74% at 3-month follow-up. The overall healing rate percent after 1 year was 80%. Conclusion: VAAFT is a safe, sphincter-saving, painless procedure and can be done as a day case with promising preliminary results, and we can repeat the treatment till cure is achieved.