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Technical Aspects of the Mouse Aortocaval Fistula
Published on: July 11, 2013
Video-assisted anal fistula treatment for complex anorectal fistula: meta-analysis
Wenjing Wang1, Yu Du1, Yiwei Wang1
1Anorectal Department, The Affiliated Hospital of Changchun University of Traditional Chinese Medicine, No.1478, Gongnong Road, Chaoyang District, Changchun City, 130000 Jilin Province, China.
Background:
Complex anal fistulas pose a significant challenge in colorectal surgery, with varying treatment outcomes. Video-assisted anal fistula treatment (VAAFT) has emerged as a promising approach, but its efficacy and safety remain to be fully established.
Methods:
A comprehensive literature search was conducted across multiple databases, including PubMed, Scopus, Web of Science, and the Cochrane Library. The methodological quality of included studies was assessed using the Newcastle-Ottawa Scale, and risk of bias was evaluated. Random-effect meta-analyses were employed to pool estimates of VAAFT's efficacy and safety outcomes compared with traditional surgical techniques (including seton, plug, fistulectomy with flap, Filac), presented as odds and risk ratios, along with their corresponding 95% confidence intervals.
Results:
A total of 15 observational studies were included with 999 patients. The meta-analysis results demonstrated that VAAFT is associated with a pooled odds ratio clinical success rate of 1.039 (95% confidence interval 1.026 to 1.054), reduced recurrence rate (pooled risk ratio 0.941, 95% confidence interval 0.928 to 0.955), and fewer postoperative complications (pooled risk ratio 0.93, 95% confidence interval 0.91 to 0.95). Additionally, VAAFT was linked to an improved postoperative quality of life (pooled odds ratio 1.07, 95% confidence interval 1.05 to 1.09).
Conclusion:
VAAFT is an effective and safe procedure for treating complex anal fistulas.
