428 Video-Assisted Anal Fistula Treatment: A Unit’s Five-Year Experience

Published Date: 19th June 2025

Publication Authors: Suepiantham. S, Santoro. G, Chadwick. M, Kalaiselvan. R, Samad. A, Rajaganeshan. R

Aim
Video-Assisted Anal Fistula Treatment (VAAFT) is a minimally invasive technique for the management of perianal fistulas, a common but difficult-to-treat condition. The current literature has limited data on the outcomes of VAAFT after five years. We describe our unit’s experience with VAAFT with a minimum of five years follow-up.

Method
A prospectively maintained database of consecutive patients who underwent elective VAAFT between November 2014 and June 2016 and attended a telephone follow-up appointment in January 2022 was reviewed for demographical data. At the follow-up appointment, patients were asked to report on continence issues (Wexner score), general health satisfaction and whether they consider themselves “cured”. T-tests and Fisher Exact Tests were used, with significance set at p<0.05.

Results
Forty-eight patients were included. The median time from the initial VAAFT procedure to telephone follow-up was 78.5 months (IQR=14.5). Sixty-five percent of patients (n=31) reported themselves as cured; they were all asymptomatic apart from one. Seventy-five percent of cured patients required only one VAAFT procedure. There was no difference in cure rates based on age, BMI, smoking status, or co-morbidities (Crohn’s disease and diabetes). Significantly more female patients reported themselves as ‘cured’ (p=0.01). Only one patient experienced a complication. Among the 17 patients who did not consider themselves cured, 15 reported improved symptoms following VAAFT. The remaining two patients felt VAAFT made no difference.

Conclusion
VAAFT can be an effective and safe treatment for complex or simple perianal fistulas of cryptoglandular or Crohn’s origin, regardless of co-morbidities. However, success of VAAFT appears to diminish over time.

 

Suepiantham. S; Santoro, G; Chadwick, M; Kalaiselvan, R; Samad, A; Rajaganeshan; R. (2025). 428 Video-Assisted Anal Fistula Treatment: A Unit’s Five-Year Experience. BJS. 112(Suppl 10), p.znaf128.188. [Online]. Available at: https://doi.org/10.1093/bjs/znaf128.188 [Accessed 1 August 2025]

 

Follow up to these previous studies:

Cheung, F. Y. et al. (2018). Video-assisted anal fistula treatment: a high volume unit initial experience. Annals of the Royal College of Surgeons of England. 100 (1), p37-41.publishing.rcseng.ac.uk/doi/10.1308/rcsann.2017.0187.

Alfred, J; Santoro, G; Beggs, R; Brookes, J; Rajaganeshan, R. (2022). P014 Video assisted anal fistula treatment (VAAFT): A 5 year review. Colorectal Disease. 24(Suppl 3), p.53. [Online]. Available at: https://onlinelibrary.wiley.com/doi/10.1111/codi.16276 [Accessed 6 January 2023]

 

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