Research progress of video-assisted anal fistula treatment for anal fistula_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 ZHANG Yuru , HUANG Bin , LIU Liancheng , REN Chuncheng , WANG Min , ZHAO Tuanjie , ZHANG Zhiliang , HAN Xu

Department of Anus & Intestine Surgery, Beijing Hospital of Coloproctology, Beijing Erlonglu Hospital, Beijing 100011, P. R. China;

Corresponding author：

ZHANG Yuru, Email: zhyr_11@163.com

Keywords：

anal fistula; video-assisted anal fistula treatment; effect; minimally invasive; review

DOI：

10.7507/1007-9424.201702096

Video：

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Objective To summarize the research progression of video-assisted anal fistula treatment (VAAFT). Methods The related literatures in recent years were reviewed, and then the operation principle, operation process, advantages and disadvantages, matters needing attention, and clinical application of VAAFT were summarized. Results VAAFT is the treatment of fistulas by endoscopy. It don’t require the incision or resection of the fistula. It has the advantages of less surgical trauma, faster postoperative recovery, and less impact on the anal sphincter. The disadvantage of this method is relatively strict indications, fistula bending or horseshoe fistula is not suitable for this method. In addition, the endoscope using during the operation is a rigid mirror tube, and the operation is not convenient enough, so technical improvement is needed in the future. We should pay attention to distinguish true fistula and false fistula in clinical practice; the wall of the fistula should be adequately burned and the necrotic tissue should be cleaned; the treatment of the internal opening of anal fistula must be exact; the time of the first defecation should be appropriately delayed, and the incidence of infection should be reduced after operation. At present, the clinical reports of VAAFT are increasing gradually in foreign countries, and these reports have achieved good therapeutic effect. It is considered that this method maybe a safe and effective minimally invasive surgical treatment for anal fistula. However, there is few clinical reports on VAAFT in China, and it is still in the preliminary stage of exploration. Conclusion VAAFT is a new technology in the treatment of anal fistula, and it has advantages of minimally invasive, sphincter preservation, and so on, which is worthy of clinical application.

Citation： ZHANG Yuru, HUANG Bin, LIU Liancheng, REN Chuncheng, WANG Min, ZHAO Tuanjie, ZHANG Zhiliang, HAN Xu. Research progress of video-assisted anal fistula treatment for anal fistula. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2017, 24(12): 1536-1540. doi: 10.7507/1007-9424.201702096 Copy

1.	Nicholls RJ. Fistula in ano: an overview. Acta Chir Iugosl, 2012, 59(2): 9-13.
2.	Dudukgian H, Abcarian H. Why do we have so much trouble treating anal fistula? World J Gastroenterol, 2011, 17(28): 3292-3296.
3.	Ratto C, Litta F, Donisi L, et al. Prospective evaluation of a new device for the treatment of anal fistulas. World J Gastroenterol, 2016, 22(30): 6936-6943.
4.	Westerterp M, Volkers NA, Poolman RW, et al. Anal fistulotomy between Skylla and Charybdis. Colorectal Dis, 2003, 5(6): 549-551.
5.	Visscher AP, Schuur D, Roos R, et al. Long-term follow-up after surgery for simple and complex cryptoglandular fistulas: fecal incontinence and impact on quality of life. Dis Colon Rectum, 2015, 58(5): 533-539.
6.	Soltani A, Kaiser AM. Endorectal advancement flap for cryptoglandular or Crohn’s fistula-in-ano. Dis Colon Rectum, 2010, 53(4): 486-495.
7.	Meinero P, Mori L. Video-assisted anal fistula treatment (VAAFT): a novel sphincter-saving procedure for treating complex anal fistulas. Tech Coloproctol, 2011, 15(4): 417-422.
8.	Seow-En I, Seow-Choen F, Koh PK. An experience with video-assisted anal fistula treatment (VAAFT) with new insights into the treatment of anal fistulae. Tech Coloproctol, 2016, 20(6): 389-393.
9.	Pini Prato A, Zanaboni C, Mosconi M, et al. Preliminary results of video-assisted anal fistula treatment (VAAFT) in children. Tech Coloproctol, 2016, 20(5): 279-285.
10.	Zarin M, Khan MI, Ahmad M, et al. VAAFT: Video Assisted Anal Fistula Treatment; Bringing revolution in Fistula treatment. Pak J Med Sci, 2015, 31(5): 1233-1235.
11.	Wałęga P, Romaniszyn M, Nowak W. VAAFT: a new minimally invasive method in the diagnostics and treatment of anal fistulas--initial results. Pol Przegl Chir, 2014, 86(1): 7-10.
12.	Schwandner O. Video-assisted anal fistula treatment (VAAFT) combined with advancement flap repair in Crohn’s disease. Tech Coloproctol, 2013, 17(2): 221-225.
13.	Kochhar G, Saha S, Andley M, et al. Video-assisted anal fistula treatment. JSLS, 2014, 18(3): 1-5.
14.	张玉茹, 张秀, 何金哲, 等. 肛瘘镜治疗肛瘘一例. 中华普通外科杂志, 2015, 30(10): 769.
15.	刘海龙, 肖毅华, 张勇, 等. 一种新型视频辅助肛瘘治疗技术治疗复杂性肛瘘的初步疗效分析. 中华胃肠外科杂志, 2015, 18(12): 1207-1210.
16.	Rojanasakul A, Pattanaarun J, Sahakitrungruang C, et al. Total anal sphincter saving technique for fistula-in-ano; the ligation of intersphincteric fistula tract. J Med Assoc Thai, 2007, 90(3): 581-586.
17.	Sileri P, Franceschilli L, Angelucci GP, et al. Ligation of the intersphincteric fistula tract (LIFT) to treat anal fistula: early results from a prospective observational study. Tech Coloproctol, 2011, 15(4): 413-416.
18.	Tan KK, Tan IJ, Lim FS, et al. The anatomy of failures following the ligation of intersphincteric tract technique for anal fistula: a review of 93 patients over 4 years. Dis Colon Rectum, 2011, 54(11): 1368-1372.
19.	Ooi K, Skinner I, Croxford M, et al. Managing fistula-in-ano with ligation of the intersphincteric fistula tract procedure: the Western Hospital experience. Colorectal Dis, 2012, 14(5): 599-603.
20.	Abcarian AM, Estrada JJ, Park J, et al. Ligation of intersphincteric fistula tract: early results of a pilot study. Dis Colon Rectum, 2012, 55(7): 778-782.
21.	Shanwani A, Nor AM, Amri N. Ligation of the intersphincteric fistula tract (LIFT): a sphincter-saving technique for fistula-in-ano. Dis Colon Rectum, 2010, 53(1): 39-42.
22.	Bleier JI, Moloo H, Goldberg SM. Ligation of the intersphincteric fistula tract: an effective new technique for complex fistulas. Dis Colon Rectum, 2010, 53(1): 43-46.
23.	Aboulian A, Kaji AH, Kumar RR. Early result of ligation of the intersphincteric fistula tract for fistula-in-ano. Dis Colon Rectum, 2011, 54(3): 289-292.
24.	Mushaya C, Bartlett L, Schulze B, et al. Ligation of intersphincteric fistula tract compared with advancement flap for complex anorectal fistulas requiring initial seton drainage. Am J Surg, 2012, 204(3): 283-289.
25.	van Onkelen RS, Gosselink MP, Schouten WR. Ligation of the intersphincteric fistula tract in low transsphincteric fistulae: a new technique to avoid fistulotomy. Colorectal Dis, 2013, 15(5): 587-591.
26.	van Onkelen RS, Gosselink MP, Schouten WR. Is it possible to improve the outcome of transanal advancement flap repair for high transsphincteric fistulas by additional ligation of the intersphincteric fistula tract? Dis Colon Rectum, 2012, 55(2): 163-166.
27.	Sirany AM, Nygaard RM, Morken JJ. The ligation of the intersphincteric fistula tract procedure for anal fistula: a mixed bag of results. Dis Colon Rectum, 2015, 58(6): 604-612.
28.	Fisher OM, Raptis DA, Vetter D, et al. An outcome and cost analysis of anal fistula plug insertion vs endorectal advancement flap for complex anal fistulae. Colorectal Dis, 2015, 17(7): 619-626.
29.	张少军, 杨巍. 经括约肌间瘘管结扎术治疗肛瘘的临床现状. 华西医学, 2013, 28(2): 302-305.
30.	邵万金. 括约肌间瘘管结扎术治疗肛瘘的过去、现在和将来. 中华胃肠外科杂志, 2015, 18(12): 1200-1202.
31.	曾翔辉, 刘羽, 曾祥福. 括约肌间瘘管结扎术治疗复杂性肛瘘. 中华普通外科杂志, 2015, 30(1): 63-64.
32.	胡业晓, 金纯, 金照, 等. 肛瘘栓治疗肛瘘的临床疗效. 中华普通外科杂志, 2017, 32(4): 367-368.
33.	Johnson EK, Gaw JU, Armstrong DN. Efficacy of anal fistula plug vs. fibrin glue in closure of anorectal fistulas. Dis Colon Rectum, 2006, 49(3): 371-376.
34.	Champagne BJ, O’Connor LM, Ferguson M, et al. Efficacy of anal fistula plug in closure of cryptoglandular fistulas: long-term follow-up. Dis Colon Rectum, 2006, 49(12): 1817-1821.
35.	Safar B, Jobanputra S, Sands D, et al. Anal fistula plug: initial experience and outcomes. Dis Colon Rectum, 2009, 52(2): 248-252.
36.	Lawes DA, Efron JE, Abbas M, et al. Early experience with the bioabsorbable anal fistula plug. World J Surg, 2008, 32(6): 1157-1159.

1. Nicholls RJ. Fistula in ano: an overview. Acta Chir Iugosl, 2012, 59(2): 9-13.
2. Dudukgian H, Abcarian H. Why do we have so much trouble treating anal fistula? World J Gastroenterol, 2011, 17(28): 3292-3296.
3. Ratto C, Litta F, Donisi L, et al. Prospective evaluation of a new device for the treatment of anal fistulas. World J Gastroenterol, 2016, 22(30): 6936-6943.
4. Westerterp M, Volkers NA, Poolman RW, et al. Anal fistulotomy between Skylla and Charybdis. Colorectal Dis, 2003, 5(6): 549-551.
5. Visscher AP, Schuur D, Roos R, et al. Long-term follow-up after surgery for simple and complex cryptoglandular fistulas: fecal incontinence and impact on quality of life. Dis Colon Rectum, 2015, 58(5): 533-539.
6. Soltani A, Kaiser AM. Endorectal advancement flap for cryptoglandular or Crohn’s fistula-in-ano. Dis Colon Rectum, 2010, 53(4): 486-495.
7. Meinero P, Mori L. Video-assisted anal fistula treatment (VAAFT): a novel sphincter-saving procedure for treating complex anal fistulas. Tech Coloproctol, 2011, 15(4): 417-422.
8. Seow-En I, Seow-Choen F, Koh PK. An experience with video-assisted anal fistula treatment (VAAFT) with new insights into the treatment of anal fistulae. Tech Coloproctol, 2016, 20(6): 389-393.
9. Pini Prato A, Zanaboni C, Mosconi M, et al. Preliminary results of video-assisted anal fistula treatment (VAAFT) in children. Tech Coloproctol, 2016, 20(5): 279-285.
10. Zarin M, Khan MI, Ahmad M, et al. VAAFT: Video Assisted Anal Fistula Treatment; Bringing revolution in Fistula treatment. Pak J Med Sci, 2015, 31(5): 1233-1235.
11. Wałęga P, Romaniszyn M, Nowak W. VAAFT: a new minimally invasive method in the diagnostics and treatment of anal fistulas--initial results. Pol Przegl Chir, 2014, 86(1): 7-10.
12. Schwandner O. Video-assisted anal fistula treatment (VAAFT) combined with advancement flap repair in Crohn’s disease. Tech Coloproctol, 2013, 17(2): 221-225.
13. Kochhar G, Saha S, Andley M, et al. Video-assisted anal fistula treatment. JSLS, 2014, 18(3): 1-5.
14. 张玉茹, 张秀, 何金哲, 等. 肛瘘镜治疗肛瘘一例. 中华普通外科杂志, 2015, 30(10): 769.
15. 刘海龙, 肖毅华, 张勇, 等. 一种新型视频辅助肛瘘治疗技术治疗复杂性肛瘘的初步疗效分析. 中华胃肠外科杂志, 2015, 18(12): 1207-1210.
16. Rojanasakul A, Pattanaarun J, Sahakitrungruang C, et al. Total anal sphincter saving technique for fistula-in-ano; the ligation of intersphincteric fistula tract. J Med Assoc Thai, 2007, 90(3): 581-586.
17. Sileri P, Franceschilli L, Angelucci GP, et al. Ligation of the intersphincteric fistula tract (LIFT) to treat anal fistula: early results from a prospective observational study. Tech Coloproctol, 2011, 15(4): 413-416.
18. Tan KK, Tan IJ, Lim FS, et al. The anatomy of failures following the ligation of intersphincteric tract technique for anal fistula: a review of 93 patients over 4 years. Dis Colon Rectum, 2011, 54(11): 1368-1372.
19. Ooi K, Skinner I, Croxford M, et al. Managing fistula-in-ano with ligation of the intersphincteric fistula tract procedure: the Western Hospital experience. Colorectal Dis, 2012, 14(5): 599-603.
20. Abcarian AM, Estrada JJ, Park J, et al. Ligation of intersphincteric fistula tract: early results of a pilot study. Dis Colon Rectum, 2012, 55(7): 778-782.
21. Shanwani A, Nor AM, Amri N. Ligation of the intersphincteric fistula tract (LIFT): a sphincter-saving technique for fistula-in-ano. Dis Colon Rectum, 2010, 53(1): 39-42.
22. Bleier JI, Moloo H, Goldberg SM. Ligation of the intersphincteric fistula tract: an effective new technique for complex fistulas. Dis Colon Rectum, 2010, 53(1): 43-46.
23. Aboulian A, Kaji AH, Kumar RR. Early result of ligation of the intersphincteric fistula tract for fistula-in-ano. Dis Colon Rectum, 2011, 54(3): 289-292.
24. Mushaya C, Bartlett L, Schulze B, et al. Ligation of intersphincteric fistula tract compared with advancement flap for complex anorectal fistulas requiring initial seton drainage. Am J Surg, 2012, 204(3): 283-289.
25. van Onkelen RS, Gosselink MP, Schouten WR. Ligation of the intersphincteric fistula tract in low transsphincteric fistulae: a new technique to avoid fistulotomy. Colorectal Dis, 2013, 15(5): 587-591.
26. van Onkelen RS, Gosselink MP, Schouten WR. Is it possible to improve the outcome of transanal advancement flap repair for high transsphincteric fistulas by additional ligation of the intersphincteric fistula tract? Dis Colon Rectum, 2012, 55(2): 163-166.
27. Sirany AM, Nygaard RM, Morken JJ. The ligation of the intersphincteric fistula tract procedure for anal fistula: a mixed bag of results. Dis Colon Rectum, 2015, 58(6): 604-612.
28. Fisher OM, Raptis DA, Vetter D, et al. An outcome and cost analysis of anal fistula plug insertion vs endorectal advancement flap for complex anal fistulae. Colorectal Dis, 2015, 17(7): 619-626.
29. 张少军, 杨巍. 经括约肌间瘘管结扎术治疗肛瘘的临床现状. 华西医学, 2013, 28(2): 302-305.
30. 邵万金. 括约肌间瘘管结扎术治疗肛瘘的过去、现在和将来. 中华胃肠外科杂志, 2015, 18(12): 1200-1202.
31. 曾翔辉, 刘羽, 曾祥福. 括约肌间瘘管结扎术治疗复杂性肛瘘. 中华普通外科杂志, 2015, 30(1): 63-64.
32. 胡业晓, 金纯, 金照, 等. 肛瘘栓治疗肛瘘的临床疗效. 中华普通外科杂志, 2017, 32(4): 367-368.
33. Johnson EK, Gaw JU, Armstrong DN. Efficacy of anal fistula plug vs. fibrin glue in closure of anorectal fistulas. Dis Colon Rectum, 2006, 49(3): 371-376.
34. Champagne BJ, O’Connor LM, Ferguson M, et al. Efficacy of anal fistula plug in closure of cryptoglandular fistulas: long-term follow-up. Dis Colon Rectum, 2006, 49(12): 1817-1821.
35. Safar B, Jobanputra S, Sands D, et al. Anal fistula plug: initial experience and outcomes. Dis Colon Rectum, 2009, 52(2): 248-252.
36. Lawes DA, Efron JE, Abbas M, et al. Early experience with the bioabsorbable anal fistula plug. World J Surg, 2008, 32(6): 1157-1159.

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Research progress of video-assisted anal fistula treatment for anal fistula

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