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.

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

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

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

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

General Anaesthesia – 11 patients Spinal Anaesthesia – 37 patients

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

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

PRE OPERATIVE

POST OPERATIVE

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

3 MONTHS POST OPERATIVE

RECURRENCE

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

RETURN TO NORMALCY 100 % in 48 hours

SPHINTER INCONTINENCE NONE

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