Surgical endoscopy · 2026
Long-term outcomes of video-assisted anal fistula treatment.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Suepiantham Sirindhra, Santoro Giovanni, Chadwick Michael, Kalaiselvan Ramya, Samad Ajai, Rajaganeshan Rajasundaram
Аннотация
BACKGROUND: Anal fistula is a common and challenging condition to manage, requiring a balance between achieving healing and preserving continence. Video-assisted anal fistula treatment (VAAFT) is a minimally invasive, endoscopic approach that allows direct visualisation and debridement of the fistula tract. Although short-term outcomes are promising, evidence regarding its long-term durability remains limited. This study provides one of the longest follow-up assessments of VAAFT outcomes to date.
METHODS: This observational study utilises a prospectively maintained database of patients who underwent VAAFT between November 2014 and June 2016 at a single UK centre. All patients with a minimum of five years of follow-up were included. Data collected included sex, age, fistula type (simple vs. complex), comorbidities (inflammatory bowel disease and diabetes mellitus), smoking status, previous fistula surgery, and subsequent fistula-related procedures (if any). The primary outcome was healing, defined as the absence of fistula-related symptoms at review. Secondary outcomes were postoperative continence deterioration and complications.
RESULTS: A total of 74 patients underwent VAAFT during the study period, and 48 patients (mean age 48 years, SD 13, 58.3% male) completed a minimum of 5 years' follow-up (median 79 months, IQR 67-82). The majority (77%) were complex-type fistula (versus simple). At their most recent follow-up appointment, 66.7% achieved healing and a further 27% reported partial symptomatic improvement. Only one reported worsened continence (loss of flatus control), and there was one self-resolving haematoma. Follow-up duration was comparable between healed and symptomatic groups. No significant association was found between healing and sex, age, fistula type, or surgical history.
CONCLUSION: VAAFT provides durable symptom relief for many patients and carries a low risk of complications or continence impairment. However, long-term complete healing rates appear modest, underscoring the importance of appropriate patient selection and counselling. Further prospective studies are warranted to refine indications and optimise long-term outcomes.
METHODS: This observational study utilises a prospectively maintained database of patients who underwent VAAFT between November 2014 and June 2016 at a single UK centre. All patients with a minimum of five years of follow-up were included. Data collected included sex, age, fistula type (simple vs. complex), comorbidities (inflammatory bowel disease and diabetes mellitus), smoking status, previous fistula surgery, and subsequent fistula-related procedures (if any). The primary outcome was healing, defined as the absence of fistula-related symptoms at review. Secondary outcomes were postoperative continence deterioration and complications.
RESULTS: A total of 74 patients underwent VAAFT during the study period, and 48 patients (mean age 48 years, SD 13, 58.3% male) completed a minimum of 5 years' follow-up (median 79 months, IQR 67-82). The majority (77%) were complex-type fistula (versus simple). At their most recent follow-up appointment, 66.7% achieved healing and a further 27% reported partial symptomatic improvement. Only one reported worsened continence (loss of flatus control), and there was one self-resolving haematoma. Follow-up duration was comparable between healed and symptomatic groups. No significant association was found between healing and sex, age, fistula type, or surgical history.
CONCLUSION: VAAFT provides durable symptom relief for many patients and carries a low risk of complications or continence impairment. However, long-term complete healing rates appear modest, underscoring the importance of appropriate patient selection and counselling. Further prospective studies are warranted to refine indications and optimise long-term outcomes.