Video‐assisted anal fistula treatment in combination with ligation of the intersphincteric fistula tract in the treatment of complex transsphincteric fistulas – a video vignette

2020 ◽  
Vol 22 (9) ◽  
pp. 1204-1205 ◽  
Author(s):  
D. Karlović ◽  
D. Kršul ◽  
Đ. Bačić ◽  
M. Zelić
Keyword(s):  
Anal Fistula ◽  
Fistula Tract ◽  
Video Assisted ◽  
Intersphincteric Fistula ◽  
Fistula Treatment ◽  
Video Vignette

scholarly journals Сучасні методи хірургічного лікування поєднаної патології анального каналу і прямої кишки

2018 ◽  
Author(s):  
M. P. Zakharash ◽  
V. V. Balytskyy ◽  
O. G. Kuryk
Keyword(s):  
Anal Fistula ◽  
Fistula Tract ◽  
Video Assisted ◽  
Intersphincteric Fistula ◽  
Fistula Treatment

Актуальність проблеми поєднаної патології анального каналу і прямої кишки  досить висока, що на сьогодні зумовлено стрімко зростаючою  кількістю проктологічних захворювань, а також відсутністю єдиного підходу щодо  хірургічного лікування цієї категорії пацієнтів. Крім того, вивченню даної проблеми присвячена досить незначна кількість публікацій з результатами наукових досліджень. Серед  ускладнень після комбінованих операційних втручань на анальному каналі і прямій кишці з приводу їх поєднаної патології найчастіше зустрічаються рубцеві стриктури анального каналу, недостатність анального сфінктера, а також  грубі рубцеві деформації періанальних і параректальних ділянок та  промежини. Впродовж останнього десятиліття широкого застосування набули “гібридні” операції в лікуванні хронічного геморою III–IV стадії в комбінації з іншою патологією анального каналу і прямої кишки. Вони включають поєднання деартеріалізації гемороїдальних вузлів із мукопексією або латексне лігування гемороїдальних вузлів, їх ліфтинг та мукопексію з видаленням супутньої патології анального каналу. У зв’язку із прогресивним розвитком сучасних технологій у практику колопроктологів почали швидко впроваджуватись такі сучасні методи хірургічного лікування аноректальної патології, як електротермічна система “Liga Sure”, ультразвуковий гармонічний скальпель “Ultra Cision”, лазерні технології в лікуванні анальних тріщин, хронічного геморою та парапроктиту (LHP, FiLaC), плазменний скальпель, біполярна системи “En Seal”, радіохвильовий скальпель “Surgitron”, а також методики LIFT (ligation of intersphincteric fistula tract) та VAAFT (Video Assisted Anal Fistula Treatment), які зменшили тривалість операцій, об’єм крововтрати, інтенсивність больового синдрому, але, на жаль, не позбавили пацієнтів таких ускладнень, як рецидиви захворювання, післяопераційні кровотечі та рубцеві стриктури анального каналу.Отже, актуальність проблеми поєднаної патології анального каналу і прямої кишки спонукає до розробки і впровадження в клінічну практику нових високоефективних методів хірургічного лікування даної патології, які б забезпечували відсутність ускладнень  в післяопераційному періоді і швидку медико-соціальну реабілітацію пацієнтів.

Video-Assisted Modified Ligation of the Intersphincteric Fistula Tract, an Integration of 2 Minimally Invasive Techniques for the Treatment of Parks Type II Anal Fistulas

2020 ◽  
pp. 155335062097802
Author(s):  
Yi-Feng Wu ◽  
Bi-Chun Zheng ◽  
Quan Chen ◽  
Xu-Dong Chen ◽  
Shao-Shun Ye ◽  
...  
Keyword(s):  
Anal Fistula ◽  
Test Group ◽  
Severity Index ◽  
Fistula Tract ◽  
Control Group ◽  
Type Ii ◽  
Anal Fistulas ◽  
Video Assisted ◽  
Significant Difference ◽  
Intersphincteric Fistula

Introduction. Complex anal fistula (CAF) is a challenging anorectal condition. Although numerous treatments for its management have been proposed, none is ideal. Herein, we investigated the clinical efficacy of video-assisted modified ligation of the intersphincteric fistula tract (LIFT) in comparison with the incision-thread-drawing procedure for Parks type II anal fistulas. Methods. Male and female adult patients with Parks type II anal fistula who were randomized to receive one of two procedures in the Anorectal Surgery Unit of the Affiliated People’s Hospital of Ningbo University: video-assisted modified LIFT (test group, 30 cases) or incision thread drawing (control group, 30 cases). Healing and recurrence, postoperative pain, and postoperative autonomous anal control ability were compared. Results. In the test group, the pain scores were significantly lower ( P = .001) and wound healing was faster ( P = .001). However, there were no marked differences between groups in operative efficacy or postoperative infection rate (all P > .05). We followed all the patients for more than 18 months, with the test group having lower Jorge–Wexner incontinence ( P = .005) and fecal incontinence (FI) severity index ( P = .000) scores. No significant difference in recurrence ( χ2 = .351, P = .554) or healing ( χ2 = 1.071, P = .301) rate was found between the 2 groups. Conclusions. We established that video-assisted modified LIFT is superior in repairing Parks type II anal fistulas, with less trauma, quicker recovery, and better anal function.

The LIFT (ligation of the intersphincteric fistula tract) procedure for a transsphincteric posterior anal fistula – a video vignette

2020 ◽  
Vol 22 (10) ◽  
pp. 1465-1466
Author(s):  
N. E. Samalavicius ◽  
V. Klimasauskiene ◽  
V. Nausediene ◽  
V. Cereska ◽  
A. Dulskas
Keyword(s):  
Anal Fistula ◽  
Fistula Tract ◽  
Intersphincteric Fistula ◽  
Video Vignette

scholarly journals Sphincter Preserving Techniques in Anal Fistula Treatment

2021 ◽  
Author(s):  
Dorian Kršul ◽  
Damir Karlović ◽  
Đordano Bačić ◽  
Marko Zelić
Keyword(s):  
Anal Fistula ◽  
Advancement Flap ◽  
High Rate ◽  
Fistula Tract ◽  
Colorectal Surgeon ◽  
Intersphincteric Fistula ◽  
Fistula Treatment ◽  
Meta Analyses ◽  
Methods Of Treatment

Complex anal fistulas present a challenge to even a seasoned colorectal surgeon due to high rate of recurrence and a real possibility of fecal incontinence if treated with conventional methods (e.g., fistulotomy, fistulectomy, seton placement). Although the illness is benign in nature, it can significantly decrease patient’s quality of life because of symptoms like pain and soiling. Given those facts, minimally invasive or sphincter preserving methods of treatment were introduced. Some of these include: Video-assisted anal fistula treatment (VAAFT), ligation of intersphincteric fistula tract (LIFT), Fistula-tract laser closure (FILAC), rectal advancement flap (RAF), treatment with platelet cells and combinations of techniques. This chapter would be an overview of these novel techniques with reference to latest clinical trials and meta-analyses.

scholarly journals Video-assisted anal fistula treatment: technical considerations and preliminary results of the first brazilian experience

2014 ◽  
Vol 27 (1) ◽  
pp. 77-81 ◽  
Author(s):  
Carlos Ramon Silveira MENDES ◽  
Luciano Santana de Miranda FERREIRA ◽  
Ricardo Aguiar SAPUCAIA ◽  
Meyline Andrade LIMA ◽  
Sergio Eduardo Alonso ARAUJO
Keyword(s):  
Anal Fistula ◽  
Fistula Tract ◽  
Anorectal Fistula ◽  
Treatment Technique ◽  
Internal Opening ◽  
Direct Closure ◽  
Invasive Approach ◽  
Internal Fistula ◽  
Video Assisted ◽  
Fistula Treatment

Backgroung : Anorectal fistula represents an epithelized communication path of infectious origin between the rectum or anal canal and the perianal region. The association of endoscopic surgery with the minimally invasive approach led to the development of the video-assisted anal fistula treatment. Aim : To describe the technique and initial experience with the technique video-assisted for anal fistula treatment. Technique : A Karl Storz video equipment was used. Main steps included the visualization of the fistula tract using the fistuloscope, the correct localization of the internal fistula opening under direct vision, endoscopic treatment of the fistula and closure of the internal opening which can be accomplished through firing a stapler, cutaneous-mucosal flap, or direct closure using suture. Results : The mean distance between the anal verge and the external anal orifice was 5.5 cm. Mean operative time was 31.75 min. In all cases, the internal fistula opening could be identified after complete fistuloscopy. In all cases, internal fistula opening was closed using full-thickness suture. There were no intraoperative or postoperative complications. After a 5-month follow-up, recurrence was observed in one (12.5%) patient. Conclusion : Video-assisted anal fistula treatment is feasible, reproducible, and safe. It enables direct visualization of the fistula tract, internal opening and secondary paths.

Video-Assisted Ligation of Intersphincteric Fistula Tract for Complex Anal Fistula: Technique and Preliminary Outcomes

2020 ◽  
Vol 63 (11) ◽  
pp. 1534-1540
Author(s):  
Worrawit Wanitsuwan ◽  
Karuna Junmitsakul ◽  
Supakool Jearanai ◽  
Varut Lohsiriwat
Keyword(s):  
Anal Fistula ◽  
Fistula Tract ◽  
Complex Anal Fistula ◽  
Video Assisted ◽  
Intersphincteric Fistula

scholarly journals Video-Assisted Anal Fistula Treatment: Pros and Cons of This Minimally Invasive Method for Treatment of Perianal Fistulas

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Michal Romaniszyn ◽  
Piotr Walega
Keyword(s):  
Anal Fistula ◽  
Fistula Tract ◽  
Perianal Fistulas ◽  
Video Assisted ◽  
Invasive Method ◽  
Pros And Cons ◽  
Fistula Treatment ◽  
Selection Of Patients ◽  
Selection Of

Purpose. The purpose of this paper is to present results of a single-center, nonrandomized, prospective study of the video-assisted anal fistula treatment (VAAFT). Methods. 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. Results. 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. Conclusions. 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.

Video‐assisted anal fistula treatment (VAAFT) assisted seton placement – a video vignette

2019 ◽  
Vol 21 (12) ◽  
pp. 1462-1462 ◽  
Author(s):  
P. Tozer ◽  
K. Sahnan ◽  
S. Adegbola ◽  
S. Shaikh ◽  
P. Lung
Keyword(s):  
Anal Fistula ◽  
Video Assisted ◽  
Fistula Treatment ◽  
Video Vignette ◽  
Seton Placement

Stem Cell Therapy for Anal Fistula Treatment – Video Vignette

2021 ◽  
Author(s):  
María Jose Cuevas López ◽  
Maria L Reyes‐Diaz ◽  
Jorge Manuel Vázquez‐Monchul ◽  
Javier Padillo ◽  
Fernando de la Portilla
Keyword(s):  
Stem Cell ◽  
Cell Therapy ◽  
Anal Fistula ◽  
Stem Cell Therapy ◽  
Fistula Treatment ◽  
Video Vignette

scholarly journals The Use of Seton as a Bridge to Definitive Ligation of the Intersphincteric Fistula Tract Procedure for Fistula-in-ano: A Systematic Review and Meta-analysis

2021 ◽  
Author(s):  
Carlos Placer-Galán ◽  
Jose Mª Enriquez-Navascués ◽  
Tania Pastor-Bonel ◽  
Ignacio Aguirre-Allende ◽  
Yolanda Saralegui-Ansorena
Keyword(s):  
Systematic Review ◽  
Anal Fistula ◽  
Meta Analysis ◽  
Fistula Tract ◽  
Cochrane Library ◽  
Fistula In Ano ◽  
Intersphincteric Fistula ◽  
The Impact ◽  
Seton Placement ◽  
Primary Healing

Abstract Background There is still controversy over the usefulness of seton placement prior to the ligation of the intersphincteric fistula tract (LIFT) surgery in the management of anal fistula. Objective To evaluate the impact of preoperative seton placement on the outcomes of LIFT surgery for the management of fistula-in-ano. Design systematic review and meta-analysis. Data Sources A search was performed on the MEDLINE (PubMed), EMBASE, Scopus, Web of Science, Cochrane Library and Google Scholar databases. Study Selection Original studies without language restriction reporting the primary healing rates with and without seton placement as a bridge to definitive LIFT surgery were included. Intervention The intervention assessed was the LIFT with and without prior seton placement. Main Outcome Measures The main outcome was defined as the primary healing rate with and without the use of seton as a bridge to definitive LIFT surgery. Results Ten studies met the criteria for systematic review, all retrospective, with a pooled study population of 772 patients. There were no significant differences in the percentages of recurrence between patients with and without seton placement (odds ratio [OR] 1.02; 95% confidence interval [CI] 0.73–1.43: p = 0.35). The I2 value was 9%, which shows the homogeneity of the results among the analyzed studies. The 10 included studies demonstrated a weighted average overall recurrence of 38% (interquartile range [IQR] 27–42.7%), recurrence with the use of seton was 40% (IQR 26.6–51.2%), and without its use, the recurrence rate was 51.3% (IQR 31.3–51.3%) Limitations The levels of evidence found in the available literature were relatively fair, as indicated after qualitative evaluation using the Newcastle-Ottawa scale and the Attitude Heading Reference System (AHRS) evidence levels. Conclusions Our meta-analysis suggests that the placement of seton as a bridge treatment prior to LIFT surgery does not significantly improve long-term anal fistula healing outcomes. Ligation of the intersphincteric fistula tract surgery can be performed safely and effectively with no previous seton placement.International prospective register of systematic reviews—PROSPERO registration number: CDR42020149173.

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