Surgical treatment of trans‐sphincteric anal fistulas with the Fat GRAFT technique: a minimally invasive procedure. (2nd August 2017)

• Record Type: Journal Article
• Authors: Stroumza, N.; Fusco, G.; Laporte, J.; Nail Barthelemy, R.; Houry, S.; Atlan, M.
• Is Part Of: Colorectal disease. Volume 19:Number 8(2017)
• Page Start: e316
• Page End: e319
• Publication Date: 2017-08-02
• Subjects: Anal fistula -- fat grafting -- lipofilling -- recurrence -- trans‐sphincteric; Colon (Anatomy) -- Diseases -- Periodicals; Rectum -- Diseases -- Periodicals; 616.34
• DOI: 10.1111/codi.13782
• Languages: English
• ISSNs: 1462-8910

Abstract

Abstract: Aim: Anal fistulas are common pathologies with a significant social impact; however, their treatment is often complex and the recurrence rate can be significant. Some surgical treatments for fistula are also associated with the risk of sphincter injury. In this technical note, we aim to evaluate the feasibility and efficacy of the Fat GRAFT technique (Fat Grafting in Anal Fistula Treatment) in the treatment of recurrent anal fistulas. Method: All patients presenting with recurrent trans‐sphincteric anal fistulas over an 18‐month period were included. After abdominal fat harvesting and fat preparation, fat grafting was performed in the track and peripheral area of the fistula. The internal and external openings of the fistula were closed to maximally preserve the retention of the adipocyte graft in the fistula. Results: Eleven patients underwent the Fat GRAFT procedure (seven men, four women). The average re‐injected volume for each fistula was 21 ml (range 10–30 ml). The postoperative course was uneventful. At 6 months three patients developed recurrence (73% healed). There were no postoperative complications. Conclusion: The Fat GRAFT technique appears to be a promising technique with a low risk of anal incontinence, in contrast to other techniques. This method was effective in > 70% of patients in a single session.