A Prospective Interventional Study To Test Efficacy Of Perfact Procedure In The Treatment Of Perianal Fistulas
Jignesh A Gandhi, Pravin H Shinde, Tarun C Shetty
INTRODUCTION: A prospective interventional study to test efficacy of PERFACT procedure in the treatment of perianal fistulas. MATERIALS AND METHODS: All patients with fistula in ano operated by THE PERFACT PROCEDURE were enrolled in a prospective interventional study starting from December 2016 to December 2017. Last case was enrolled in September 2017 to have a 4 month follow up period. SAMPLE SIZE: 20 INCLUSION CRITERIA: all cases of perianal fistulas were included in this study EXCLUSION CRITERIA: patients not consenting to get enrolled in the study Patients below 13 years of age METHODOLOGY: All cases to be operated by PERFACT PROCEDURE were followed up post procedure with daily dressings and the outcome wasdocumented in context with the three criteriaâ€™s: POST-OPERATIVE PAIN Recurrence or persistence of fistula/ patients requiring a redo surgery Continence levels following the procedure RESULTS: 1. 20 cases were included in the study with a female to male ratio of 16:4. The mean age being 35 years +/-12.8 years with a maximum age of 62 and a minimum age of 22. 2. According to parks classification among the 20 cases included in the study 75% were intersphincteric, transsphincteric (15%), supralevator (10%). 3. Among the 20 cases operated, 16 cases healed (80%), 1 case did not heal (5%), 1 case healed but recurred within four months (5%), 2 cases were lost to follow up (10%). All the 16 cases healed within 4-8 weeks. 4. Among the 20 cases, cases with no associated MRI findings (simple fistulas) were 5, out of which 4 cases healed and 1 case was lost to follow up. 5. Cases with 1 associated MRI finding were 7, of which 6 cases healed, 1 was lost to follow up. 6. Cases with 2 associated MRI findings were 5, out of which 3 cases healed, 1 did not heal, 1 case did heal but showed recurrence at the end of four months. 7. Cases with 3 associated MRI findings were 3, of which all 3 cases healed. 8. In this study postoperative pain has been measured using the visual analogue scale. In all the operated cases VAS score is 0 9. In this study the continence levels were assessed by directly asking the patients in the postoperative period. Among all the 20 cases, none of the patients had any continence issues. CONCLUSION: The above study has thus proven the efficacy of the PERFACT PROCEDURE in treatment of both simple as well as complex perianal fistulas.
Perianal fistula, Perfact procedure, continence, recurrence, VAS score