Romaniszyn Michal, Walega Piotr
3rd Department of General Surgery, Jagiellonian University Medical College, Kraków, Poland.
Gastroenterol Res Pract. 2017;2017:9518310. doi: 10.1155/2017/9518310. Epub 2017 Jun 7.
The purpose of this paper is to present results of a single-center, nonrandomized, prospective study of the video-assisted anal fistula treatment (VAAFT).
68 consecutive patients with perianal fistulas were operated on using the VAAFT technique. 30 of the patients had simple fistulas, and 38 had complex fistulas. The mean follow-up time was 31 months.
The overall healing rate was 54.41% (37 of the 68 patients healed with no recurrence during the follow-up period). The results varied depending on the type of fistula. The success rate for the group with simple fistulas was 73.3%, whereas it was only 39.47% for the group with complex fistulas. Female patients achieved higher healing rates for both simple (81.82% versus 68.42%) and complex fistulas (77.78% versus 27.59%). There were no major complications.
The results of VAAFT vary greatly depending on the type of fistula. The procedure has some drawbacks due to the rigid construction of the fistuloscope and the diameter of the shaft. The electrocautery of the fistula tract from the inside can be insufficient to close wide tracts. However, low risk of complications permits repetition of the treatment until success is achieved. Careful selection of patients is advised.
本文旨在介绍一项关于视频辅助肛瘘治疗（VAAFT）的单中心、非随机、前瞻性研究的结果。
连续68例肛周瘘患者接受了VAAFT技术手术。其中30例患者为单纯性肛瘘，38例为复杂性肛瘘。平均随访时间为31个月。
总体愈合率为54.41%（68例患者中有37例在随访期间愈合且无复发）。结果因肛瘘类型而异。单纯性肛瘘组的成功率为73.3%，而复杂性肛瘘组仅为39.47%。女性患者无论是单纯性肛瘘（81.82%对68.42%）还是复杂性肛瘘（77.78%对27.59%）的愈合率都更高。无重大并发症。
VAAFT的结果因肛瘘类型而异。由于瘘管镜的刚性结构和镜身直径，该手术存在一些缺点。从内部对瘘管进行电灼可能不足以闭合较宽的瘘管。然而，并发症风险低允许重复治疗直至成功。建议仔细选择患者。
