The therapeutic evaluation of video-assisted anal fistula treatment for Parks II anal fistula

Objective To evaluate video-assisted anal fistula treatment (VAAFT) for Parks type Ⅱ anal fistula. Methods 40 Parks type Ⅱ anal fistula patients underwent VAAFT procedure from June 2015 to June 2017. Results were compared with 40 cases treated by incision and thread drawing. Results There was no significant difference between the two groups for curative effect, postoperative urinary retention, wound edema, bleeding and recurrence rate after 6 months of operation (90% vs. 95%, χ2=0.722, P=0.697; 5% vs. 8%, χ2=0.213, P=1.0; 2% vs. 8%, χ2=1.053, P=0.615; 0 vs. 5%, χ2=2.051, P=0.494; 10% vs. 5%, χ2=0.721, P=0.675). Pain on first day and one week after operation in the VAAFT was less [(1.9±0.6) vs. (3.7±1.0), t=9.438, P=0.001; (0.9±0.7) vs. (1.9±0.8), t=6.269, P=0.001], hospital stay was shorter [8.4±1.3) d vs. (9.2±2.2) d, t=2.030, P=0.047], wound healing was faster [(27±8) d vs. (38±6) d, t=7.328, P=0.001]. The Jorge-Wexner incontinence score [(0.5±0.7) vs. (1.2±1.3), t=2.951, P=0.005] and the fecal incontinence severity index [(1.1±1.6) vs. (5.1±3.2), t=7.097, P=0.001] were lower in patients receiving VAAFT procedure. Conclusion Video-assisted anal fistula treatment is a safe and effective surgical method with the advantages of less trauma, and pain, quicker recovery and no damage to the anal sphincter. Key words: Rectal fistula; Surgical procedures, minimally invasive