LAUSR

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.