Symptom amelioration in Crohn’s perianal fistulas using video assisted anal fistula treatment (VAAFT)

Symptom amelioration in Crohn’s perianal fistulas using video assisted anal fistula treatment... Abstract A third of patients with Crohn’s disease develop perianal fistulas. These are associated with a significant burden of symptoms and negative impact on quality of life. This study reports the use of VAAFT as a means of symptom improvement; with minimally invasive technique to access fistula track, diagnose/facilitate drainage of deep/complex secondary extensions with cauterization of excess inflammatory tissue. Methods Consecutive patients with complex Crohn’s fistula undergoing a VAAFT for symptomatic Crohn’s anal fistula were included. They were identified from a prospectively maintained database, which was interrogated from June 2015-November 2017. Patients underwent diagnostic fistuloscopy and fulguration of tracts/secondary extensions. Setons were sited/replaced after the procedure to maintain postoperative drainage. Primary endpoint was completion of the “Measure your medical outcome profile” (MYMOP2) quality of life (QoL) questionnaire at 6 weeks postoperatively. Secondary outcome measures were a decisional regret scale (DRS), post-operative complications and the thirty-day re-operation rate. Results 25 patients underwent the procedure during the study period. 21/25 patients (84%) completed MYMOP2 QoL data demonstrating a statistically significant improvement in both pain and discharge scores. 81% of patients who completed the agreed/strongly agreed that the procedure was right decision and no patient regretted undergoing the procedure. There was 1 reoperation but otherwise no complications. Conclusions This study demonstrates feasibility, safety and importantly an improvement in patient reported outcomes in a series of patients undergoing VAAFT for complex Crohn’s anal fistula. VAAFT reduces the main symptoms (pain and discharge) in patients with complex refractory anal fistulas. Vaaft, fistula, patient reported outcomes © European Crohn’s and Colitis Organisation (ECCO) 2018. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Journal of Crohn's and Colitis Oxford University Press

Symptom amelioration in Crohn’s perianal fistulas using video assisted anal fistula treatment (VAAFT)

Loading next page...
 
/lp/ou_press/symptom-amelioration-in-crohn-s-perianal-fistulas-using-video-assisted-v5DIpANYux
Publisher
Elsevier Science
Copyright
© European Crohn’s and Colitis Organisation (ECCO) 2018.
ISSN
1873-9946
eISSN
1876-4479
D.O.I.
10.1093/ecco-jcc/jjy071
Publisher site
See Article on Publisher Site

Abstract

Abstract A third of patients with Crohn’s disease develop perianal fistulas. These are associated with a significant burden of symptoms and negative impact on quality of life. This study reports the use of VAAFT as a means of symptom improvement; with minimally invasive technique to access fistula track, diagnose/facilitate drainage of deep/complex secondary extensions with cauterization of excess inflammatory tissue. Methods Consecutive patients with complex Crohn’s fistula undergoing a VAAFT for symptomatic Crohn’s anal fistula were included. They were identified from a prospectively maintained database, which was interrogated from June 2015-November 2017. Patients underwent diagnostic fistuloscopy and fulguration of tracts/secondary extensions. Setons were sited/replaced after the procedure to maintain postoperative drainage. Primary endpoint was completion of the “Measure your medical outcome profile” (MYMOP2) quality of life (QoL) questionnaire at 6 weeks postoperatively. Secondary outcome measures were a decisional regret scale (DRS), post-operative complications and the thirty-day re-operation rate. Results 25 patients underwent the procedure during the study period. 21/25 patients (84%) completed MYMOP2 QoL data demonstrating a statistically significant improvement in both pain and discharge scores. 81% of patients who completed the agreed/strongly agreed that the procedure was right decision and no patient regretted undergoing the procedure. There was 1 reoperation but otherwise no complications. Conclusions This study demonstrates feasibility, safety and importantly an improvement in patient reported outcomes in a series of patients undergoing VAAFT for complex Crohn’s anal fistula. VAAFT reduces the main symptoms (pain and discharge) in patients with complex refractory anal fistulas. Vaaft, fistula, patient reported outcomes © European Crohn’s and Colitis Organisation (ECCO) 2018. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com

Journal

Journal of Crohn's and ColitisOxford University Press

Published: May 25, 2018

There are no references for this article.

You’re reading a free preview. Subscribe to read the entire article.


DeepDyve is your
personal research library

It’s your single place to instantly
discover and read the research
that matters to you.

Enjoy affordable access to
over 18 million articles from more than
15,000 peer-reviewed journals.

All for just $49/month

Explore the DeepDyve Library

Search

Query the DeepDyve database, plus search all of PubMed and Google Scholar seamlessly

Organize

Save any article or search result from DeepDyve, PubMed, and Google Scholar... all in one place.

Access

Get unlimited, online access to over 18 million full-text articles from more than 15,000 scientific journals.

Your journals are on DeepDyve

Read from thousands of the leading scholarly journals from SpringerNature, Elsevier, Wiley-Blackwell, Oxford University Press and more.

All the latest content is available, no embargo periods.

See the journals in your area

DeepDyve

Freelancer

DeepDyve

Pro

Price

FREE

$49/month
$360/year

Save searches from
Google Scholar,
PubMed

Create lists to
organize your research

Export lists, citations

Read DeepDyve articles

Abstract access only

Unlimited access to over
18 million full-text articles

Print

20 pages / month

PDF Discount

20% off