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Dr.Manoharan Nandakishore General and Laproscopic Surgeon Apollo Hospitals,Chennai

Prospective Analysis of 48 Consecutive Cases of VAAFT. Dr.Manoharan Nandakishore General and Laproscopic Surgeon Apollo Hospitals,Chennai. CONFLICT OF INTEREST. NONE. AIM. To study the safety, efficacy and patient comfort factor in the treatment of fistula in ano with VAAFT.

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Dr.Manoharan Nandakishore General and Laproscopic Surgeon Apollo Hospitals,Chennai

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  1. Prospective Analysis of 48 Consecutive Cases of VAAFT • Dr.Manoharan Nandakishore • General and Laproscopic Surgeon • Apollo Hospitals,Chennai

  2. CONFLICT OF INTEREST NONE

  3. AIM To study the safety, efficacy and patient comfort factor in the treatment of fistula in ano with VAAFT.

  4. MATERIALS AND METHODS This was a prospective study from August 2011 to February 2012 involving 48 patients, who had presented with fistula in ano.

  5. MATERIALS AND METHODS • 9 patients – Low anal fistula • 16 patients – Intersphincteric fistula • 23 patients – Transsphincteric fistula

  6. RECURRENT FISTULA 6 of 16 Intersphincteric fistula 4 of 23 Transsphincteric fistula

  7. SPECIFIC INVESTIGATION MR fistulogram For all intersphinteric and transsphinteric cases and two cases of low anal fistula.

  8. ANAESTHESIA • General Anaesthesia – 11 patients • Spinal Anaesthesia – 37 patients

  9. CLOSURE OF INTERNAL OPENING 32 patients • 12 patients - Mucosal flap – 8 patients had glue reinforcement • 20 patients – Stapler + glue reinforcement

  10. PAIN SCORE Score 1 - 11 patients Score 2 - 29 patients Score 3 - 8 patients (GA)

  11. PRE OPERATIVE

  12. POST OPERATIVE

  13. LENGTH OF HOSPITAL STAY • 26 patients – Day care • 22 patients – 24 hours

  14. 3 MONTHS POST OPERATIVE

  15. RECURRENCE

  16. RECURRENCE Total 7 Low anal – 1 Intersphincteric -4 (2) Transsphincteric – 2(2)

  17. RETURN TO NORMALCY 100 % in 48 hours

  18. SPHINTER INCONTINENCE NONE

  19. CONCLUSION • Safe • Effective • Low morbidity • Less Post operative pain • Better convalescence • Intact sphincter control • Less mutilating

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