Lopez Marc Paul J, Onglao Mark Augustine S, Monroy Iii Hermogenes J
Division of Colorectal Surgery, Philippine General Hospital, University of the Philippines Manila, Manila, the Philippines.
Ann Coloproctol. 2020 Apr;36(2):112-118. doi: 10.3393/ac.2020.02.28. Epub 2020 Mar 16.
We determined the outcomes of patients undergoing video-assisted anal fistula treatment (VAAFT) for fistulain-ano at the Philippine General Hospital.
Twenty consecutive adult patients who underwent the VAAFT procedure from 2016-2018 were included in this investigation. Information detailing baseline demographic and clinical data, fistula type and classification, and previous surgeries were retrieved from in-hospital and operative records. Operative time, identification of the internal opening, method of internal opening closure, and occurrence of immediate postoperative complications were determined. The status of the fistula was assessed at one month, 3 months, and 6 months postoperatively based on outpatient follow-up records. The primary outcomes were healing rate and recurrence rate. Secondary outcomes were 30-day morbidity, postoperative complications, and incontinence using the Wexner score.
Eighteen patients (90%) had a preoperative diagnosis of complex fistula, and 13 patients (65%) had undergone a previous fistula surgery. Primary healing rate was 55% at 1 month, 63.16% at 3 months, and 78.95% at 6 months postoperatively. Eighteen patients (94.74%) maintained continence (Wexner score = 0) at 6 months.
Our study results suggest that VAAFT is a safe, minimally invasive technique for treatment of anal fistula and can preserve anal sphincter function. The technique has an acceptable healing rate with minimal complications.
我们确定了在菲律宾总医院接受视频辅助肛瘘治疗（VAAFT）的肛瘘患者的治疗结果。
本研究纳入了2016年至2018年连续接受VAAFT手术的20例成年患者。从住院和手术记录中检索详细的基线人口统计学和临床数据、瘘管类型和分类以及既往手术信息。确定手术时间、内口识别、内口闭合方法以及术后即刻并发症的发生情况。根据门诊随访记录，在术后1个月、3个月和6个月评估瘘管状态。主要结局为愈合率和复发率。次要结局为30天发病率、术后并发症以及使用韦克斯纳评分评估的失禁情况。
18例患者（90%）术前诊断为复杂性肛瘘，13例患者（65%）既往接受过肛瘘手术。术后1个月的一期愈合率为55%，3个月时为63.16%，6个月时为78.95%。18例患者（94.74%）在6个月时保持了大便失禁（韦克斯纳评分为0）。
我们的研究结果表明，VAAFT是一种安全、微创的肛瘘治疗技术，可保留肛门括约肌功能。该技术具有可接受的愈合率，并发症极少。
