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 involving 48 patients, who had presented with fistula in ano.

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

6. 6 of 16 Intersphincteric fistula 4 of 23 Transsphincteric fistula
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. 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 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 Low anal – 1 Intersphincteric -4 (2)
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