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Dr.Manoharan Nandakishore General and Laproscopic Surgeon Apollo Hospitals,Chennai Prospective Analysis of 48 Consecutive Cases of VAAFT.

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Presentation on theme: "Dr.Manoharan Nandakishore General and Laproscopic Surgeon Apollo Hospitals,Chennai Prospective Analysis of 48 Consecutive Cases of VAAFT."— Presentation transcript:

1 Dr.Manoharan Nandakishore General and Laproscopic Surgeon Apollo Hospitals,Chennai Prospective Analysis of 48 Consecutive Cases of VAAFT

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 2012 involving 48 patients, who had presented with fistula in ano.

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

6 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 ANAESTHESIA 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 patients Score 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 Total 7 Low anal – 1 I ntersphincteric -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

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