TY - JOUR ID - TI - Video‑Assisted Anal Fistula Treatment in the Management of Fistula‑in‑Ano: A 3‑Year Experience AU - Hussein Oudah Al‑Jasmawi, Alaa Bakir Raheem Al‑Mhanaa1, Mohammed Salih Al‑Janabi PY - 2019 VL - 16 IS - 4 SP - 267 EP - 270 JO - Medical Journal of Babylon مجلة بابل الطبية SN - 1812156X 23126760 AB - Background: Fistula‑in‑ano and especially the high and complicated type is still one of the difficult surgical problems to solve. The newpromising technique, video‑assisted anal fistula treatment (VAAFT) was done first by Professor P. Meinero in 2006. Objective: The objective ofthe study was to describe the technique and the encouraging result of VAAFT. Materials and Methods: Using Karl Storz Company fistuloscope,200 patients with anal fistulas were treated in Babylon Private Hospital in Al Hilla (Center of Babylon Governorate). This was done in two phases:diagnostic phase including visualization of fistula tract and identification of internal opening, followed by the operative phase by cauterization,curettage of the tract, irrigation using 1% mannitol solution, and closure of the internal opening using no. 1 Vicryl (polyglactin). Results: Fromthe 200 patients with anal fistulas, 40 patients (20%) had undergone classical fistula surgery. No major complications were recorded. Early and latepostoperative pain and discomfort were mild. The cases followed up at 6 weeks and 3 months postoperatively. Primary healing rate was 70% at12 weeks and 74% at 3‑month follow‑up. The overall healing rate percent after 1 year was 80%. Conclusion: VAAFT is a safe, sphincter‑saving,painless procedure and can be done as a day case with promising preliminary results, and we can repeat the treatment till cure is achieved.

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