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A Journal on Surgery

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Minerva Chirurgica 2018 Jan 23

DOI: 10.23736/S0026-4733.18.07390-X


language: English

Video-Assisted Anal Fistula Treatment (VAAFT) in the management of complex anal fistula: single center experience of 224 consecutive patients

Alessandro STAZI 1, Paolo IZZO 3, Francesco D'ANGELO 2, Monica RADICCHI 1, Manuele MAZZI 1 , Federico TOMASSINI 2 , Luciano IZZO 3, Stefano VALABREGA 2

1 General Surgery Department, Colorectal Pelvic Center, “Madonna delle Grazie”, Velletri, Roma, Italy; 2 Department of Surgical and Medical Sciences and Translational Medicine, “Sapienza” University of Rome, Rome, Italy; 3 Department of Surgery "Pietro Valdoni", "Sapienza" University of Rome, Rome, Italy


BACKGROUND: Video Assisted Anal Fistula Treatment (VAAFT) is now a mature technique, supported by many short-term published case series.
METHODS: We designed a monocentric, retrospective and observational study in order to evaluate early and long-term outcomes of VAAFT in the treatment of primary and recurrent complex anal fistula. Between November 2011 and March 2014, 224 consecutive patients affected by complex perianal fistula underwent Video Assisted Anal Fistula Treatment. Fifty-two were affected by primary and 172 by recurrent disease. We registered all intra and postoperative complications and healing rate. Median follow-up was 48 months (27-60).
RESULTS: In the primary fistula group, 40 of the 52 patients were completely healed within 3 months after surgery (77%); at 12 months, considering also 12 pts (23%) treated with a second VAAFT due to recurrent disease, the overall healing rate was 92.3% In the second group with recurrent anal fistula (172 patients), primary healing was observed in 110 patients (64%; p=0.1) within 3 months after surgery and increases to 80.2%, after 12 months (p=0.06). Few patients required analgesics in the postoperative period (33 patients-14.7%), the remaining did not require pain killers at all. All patients were able to resume daily activities within 7 days from surgery (range 2-12). Main limitation of our study was its retrospective and monocentric design.
CONCLUSIONS: VAAFT seems to be a safe and effective technique for treating primary and recurrent perianal fistula, providing a very good healing rate without sphincters impairment and allowing a very quick return to normal activities.

KEY WORDS: VAAFT - Anal fistula - Complex anal fistula

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Publication History

Article first published online: January 23, 2018
Manuscript accepted: January 5, 2018
Manuscript revised: November 27, 2017
Manuscript received: April 20, 2017

Cite this article as

Stazi A, Izzo P, Radicchi M, Mazzi M, Tomassini F et al. Video-Assisted Anal Fistula Treatment (VAAFT) in the management of complex anal fistula: single center experience of 224 consecutive patients. Minerva Chir 2018 Jan 23. DOI: 10.23736/S0026-4733.18.07390-X

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