Dr.Manoharan Nandakishore General and Laproscopic Surgeon Apollo Hospitals,Chennai
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![Page 1: Dr.Manoharan Nandakishore General and Laproscopic Surgeon Apollo Hospitals,Chennai Prospective Analysis of 48 Consecutive Cases of VAAFT.](https://reader038.fdocuments.in/reader038/viewer/2022102616/551c2d41550346ad4f8b615a/html5/thumbnails/1.jpg)
Dr.Manoharan Nandakishore
General and Laproscopic SurgeonApollo Hospitals,Chennai
Prospective Analysis of 48 Consecutive Cases of VAAFT
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CONFLICT OF INTEREST
NONE
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AIM
To study the safety, efficacy and patient comfort factor in the treatment of fistula in ano with VAAFT.
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MATERIALS AND METHODS
This was a prospective study from August 2011 to February 2012 involving 48 patients, who had presented with fistula in ano.
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MATERIALS AND METHODS
9 patients – Low anal fistula
16 patients – Intersphincteric fistula
23 patients – Transsphincteric fistula
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RECURRENT FISTULA
6 of 16 Intersphincteric fistula
4 of 23 Transsphincteric fistula
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SPECIFIC INVESTIGATION
MR fistulogram For all intersphinteric and transsphinteric cases and two cases of low anal fistula.
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ANAESTHESIA
General Anaesthesia – 11 patients
Spinal Anaesthesia – 37 patients
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CLOSURE OF INTERNAL OPENING
32 patients
12 patients - Mucosal flap – 8 patients had
glue reinforcement
20 patients – Stapler + glue reinforcement
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PAIN SCORE
Score 1 - 11 patients Score 2 - 29 patients
Score 3 - 8 patients (GA)
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PRE OPERATIVE
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POST OPERATIVE
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LENGTH OF HOSPITAL STAY
26 patients – Day care
22 patients – 24 hours
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3 MONTHS POST OPERATIVE
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RECURRENCE
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RECURRENCE
Total 7
Low anal – 1 Intersphincteric -4 (2)Transsphincteric – 2(2)
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RETURN TO NORMALCY
100 % in 48 hours
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SPHINTER INCONTINENCE
NONE
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CONCLUSION
Safe
Effective
Low morbidity
Less Post operative pain
Better convalescence
Intact sphincter control
Less mutilating
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